Most Relevant Information
Provider Data
| NPI Number: | 1003067422 |
| Provider Name: | AMANDA MARIE REILSON RD, LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 164004969 |
Most Important Dates
| Enumeration Date: | 10/03/2008 |
| Last Updated: | 10/14/2009 |
Provider Practice Location
6800 STATE ROUTE 162
MARYVILLE
IL
620628500
Practice Location Phone/Fax
| Phone: | 6183915528 |
| Fax: | 6182883638 |
Provider Mailing Location
1813 MARINE RD
SAINT JACOB
IL
622811243
Provider Mailing Phone/Fax
| Phone: | 6186443129 |
| Fax: |