Healthcare Provider Details

I. General information

NPI: 1700969938
Provider Name (Legal Business Name): CINDY C. RADA RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1518 MULBERRY AVE
MUSCATINE IA
52761-3433
US

IV. Provider business mailing address

2480 HUMMINGBIRD LN
MUSCATINE IA
52761-8435
US

V. Phone/Fax

Practice location:
  • Phone: 563-264-9317
  • Fax: 563-264-9249
Mailing address:
  • Phone: 563-264-8536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number00247
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: