Individual
ALICIA REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NDTR
Contact information
Practice address
600 PLEASANT AVE S, PARK RAPIDS, MN 56470-1431
(218) 616-3377
Mailing address
17664 SUNNY HILL DR, LAPORTE, MN 56461-5084
(952) 486-2231
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
86170823
MN
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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