Organization
DIZGROW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA K DISBROW MS RD LDN (OWNER)
(309) 828-6157
Entity
Organization
Contact information
Practice address
322 SUSAN DR STE C1, NORMAL, IL 61761-6260
(701) 484-2217
(309) 322-6475
Mailing address
1902 BERRYWOOD LN, BLOOMINGTON, IL 61704-2433
(309) 828-6157
(309) 322-6475
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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