Healthcare Provider Details

I. General information

NPI: 1043992670
Provider Name (Legal Business Name): APRIL MARIE OVERLA RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: APRIL MARIE DONTZ RDN

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9402 STEED RD
BUCKLEY MI
49620-9711
US

IV. Provider business mailing address

9402 STEED RD
BUCKLEY MI
49620-9711
US

V. Phone/Fax

Practice location:
  • Phone: 231-429-6959
  • Fax:
Mailing address:
  • Phone: 231-429-6959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number923453
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: