Individual
MRS. STACY DAWN KOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-0847
(218) 844-0704
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-0847
(218) 844-0704
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2380
MN
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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