Individual
AMANDA M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED DIETITIAN
Contact information
Practice address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
(218) 546-4646
Mailing address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
(218) 546-4646
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3785
MN
Other
Enumeration date
11/02/2017
Last updated
12/03/2020
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