Most Relevant Information
Provider Data
| NPI Number: | 1003237736 |
| Provider Name: | BRAD KITTELSON LRD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 397 |
Most Important Dates
| Enumeration Date: | 12/24/2013 |
| Last Updated: | 03/25/2014 |
Provider Practice Location
1720 UNIVERSITY DR S
FARGO
ND
581034940
Practice Location Phone/Fax
| Phone: | 7012804474 |
| Fax: |
Provider Mailing Location
PO BOX 2168
FARGO
ND
581072168
Provider Mailing Phone/Fax
| Phone: | 7012342119 |
| Fax: |