NPI 1073531646

Susan M Martodam, LRD

Practitioner Registered Dietitian Detroit Lakes, MN

Practice location

Address: 1245 Washington Ave, Detroit Lakes, MN 56501-3905
Phone: (218) 846-2000
Fax: (701) 234-2045

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 2223 (MN)

Other Dietitian, Registered providers in Minnesota →

Registry record

NPI: 1073531646
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Jul 2006
Record last updated: 16 Sep 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.