Individual
THERESA A. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LMNT
Contact information
Practice address
902 S 6TH ST, COUNCIL BLUFFS, IA 51501-6441
(712) 325-1990
Mailing address
902 S 6TH ST, COUNCIL BLUFFS, IA 51501-6441
(712) 325-1990
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
106187
IA
Other
Enumeration date
06/04/2021
Last updated
06/04/2021
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