NPI 1700415296 · live from the CMS NPI Registry
605 Dietitian, LLC
Dietitian, Registered in Harrisburg, SD. National Provider Identifier 1700415296, active.
NPI record
| NPI | 1700415296 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 276 Tiger Way Unit 1, Harrisburg, SD 57032 |
| Practice phone | 605-870-1036 |
| Mailing address | 904 E Donlin St, Miller, SD 57362 |
| Enumerated | April 6, 2020 |
| Last updated | November 10, 2021 |
| Authorized official | Kelsey Raab, Registered Dietitian |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.