Individual
RENEE LEGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
255 WHITETAIL DRAW RD, SAINT MARIES, ID 83861-9747
(208) 245-1310
(208) 245-1536
Mailing address
255 WHITETAIL DRAW RD, SAINT MARIES, ID 83861-9747
(208) 245-1310
(208) 245-1536
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
814543
AK
133V00000X
Registered Dietitian
D-510
ID
Other
Enumeration date
03/24/2008
Last updated
03/24/2008
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