Most Relevant Information
Provider Data
| NPI Number: | 1003428053 |
| Provider Name: | ABIGAIL RENN RD LN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 0695 |
Most Important Dates
| Enumeration Date: | 08/20/2020 |
| Last Updated: | 08/20/2020 |
Provider Practice Location
353 FAIRMONT BLVD
RAPID CITY
SD
577017375
Practice Location Phone/Fax
| Phone: | 6057554755 |
| Fax: |
Provider Mailing Location
353 FAIRMONT BLVD
RAPID CITY
SD
577017375
Provider Mailing Phone/Fax
| Phone: | 6057554755 |
| Fax: |