MEDICARE: ARNTSON ENTERPRISES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	729	ND

General Provider Information

NPI Number	:	1467617464
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARNTSON ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	620 7TH ST SE
Second Line	:
City	:	EAST GRAND FORKS
State	:	MN
Zip	:	56721-2362
Country	:	US
Telephone Number	:	218-779-9736
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 44TH AVE S STE 121D
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-3493
Country	:	US
Telephone Number	:	218-779-9736
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	MRS. BARBARA ARNTSON
Credential	:	MS, RD, LD
Telephone Number	:	218-779-9736

Provider Enumeration Date	:	07/20/2008
Last Update Date	:	07/21/2008

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