Individual
ABBY L MATHISTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LN
Contact information
Practice address
502 E MONROE ST, RAPID CITY, SD 57701-1400
(605) 755-4060
(605) 755-4012
Mailing address
353 FAIRMONT BLVD, ATTEN CHRISTIE MSS, RAPID CITY, SD 57701-7350
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
0000
SD
133V00000X
Registered Dietitian
0000
SD
133V00000X
Registered Dietitian
Primary
0413
SD
Other
Enumeration date
02/17/2012
Last updated
02/07/2014
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