NPI 1114623337

Alex M Richeson, MSRDNCD

Practitioner Registered Dietitian Baraboo, WI

Practice location

Address: S2845 White Eagle Rd, Baraboo, WI 53913-9064
Phone: (608) 355-1240
Fax: (608) 356-7152
Mailing address: 1430 Walnut St APT 4, Baraboo, WI 53913-2923

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X

Other Dietitian, Registered providers in Wisconsin →

Registry record

NPI: 1114623337
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Jan 2023
Record last updated: 31 Jan 2023

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.