Individual
LAURA D IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
400 S CLARK ST, BUTTE, MT 59701-2328
(406) 723-2428
Mailing address
400 S CLARK ST, BUTTE, MT 59701-2328
(406) 723-2428
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
539
MT
Other
Enumeration date
05/28/2008
Last updated
05/28/2008
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