Basic Information
| Provider Information | |||||||||
| NPI: | 1386970861 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RONDEAU | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ND, RH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2620 E PROSPECT RD | ||||||||
| Address2: | SUITE 190 | ||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805259098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702211106 | ||||||||
| FaxNumber: | 9702321050 | ||||||||
| Practice Location | |||||||||
| Address1: | 2620 E PROSPECT RD | ||||||||
| Address2: | SUITE 190 | ||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805259098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702211106 | ||||||||
| FaxNumber: | 9702321050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2009 | ||||||||
| LastUpdateDate: | 10/15/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 175F00000X | 099.0069127 | VT | Y | Other Service Providers | Naturopath |
No ID Information.