Organization
STEPHANIE EWALS NUTRITIONAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAN STJUSTE (CREDENTIALING SPECIALIST)
(631) 295-6516
Entity
Organization
Contact information
Practice address
5120 241ST AVE NW, SAINT FRANCIS, MN 55070-9388
(612) 669-4851
Mailing address
5120 241ST AVE NW, SAINT FRANCIS, MN 55070-9388
(612) 669-4851
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2025
Last updated
05/01/2025
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