Individual
MRS. MICHELLE MATHURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LRD, CDE
Contact information
Practice address
1309 17TH AVE SW, MINOT, ND 58701-6188
(716) 572-6502
Mailing address
1309 17TH AVE SW, MINOT, ND 58701
(716) 572-6502
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
733
ND
Other
Enumeration date
03/27/2007
Last updated
06/19/2017
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