Individual
MRS. MARY LOU BLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN LMNT
Contact information
Practice address
78235 ROAD 411, GOTHENBURG, NE 69138-5116
(308) 529-3534
Mailing address
78235 ROAD 411, GOTHENBURG, NE 69138-5116
(308) 529-3534
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
755
NE
Other
Enumeration date
02/12/2021
Last updated
02/19/2021
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