Individual
SHYAMALA GANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23516 BIRCH CIR, ROGERS, MN 55374-8795
(612) 273-3216
(612) 273-5039
Mailing address
23516 BIRCH CIR, ROGERS, MN 55374-8795
(612) 273-3216
(612) 273-5039
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2274
MN
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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