Individual
DEREK MICHAEL FIACCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
3250 W 66TH ST, EDINA, MN 55435-2522
(320) 309-8913
Mailing address
83 E 4TH ST, CORNING, NY 14830-3103
(607) 329-3997
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
06/03/2022
Last updated
06/07/2022
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