Individual
MAURINE THIESZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1301 W MAIN ST, LAKE CITY, IA 51449-1585
(712) 464-3171
(712) 464-3269
Mailing address
1301 W MAIN ST, LAKE CITY, IA 51449-1585
(712) 464-3171
(712) 464-3269
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00509
IA
Other
Enumeration date
02/12/2007
Last updated
01/12/2012
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