| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ANGIE ISON | 1477803617 | 2024-07-05 |
Angie Ison is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1477803617. Registration indicates Angie Ison is a provider of services with a specialization in Dietary & Nutritional Service Providers, Dietitian, Registered (Dietitian, Registered, ) (All Other Specialties & Provider Types, ) (Dietitian, Registered, Dietary & Nutritional Service Providers)
| Entity Type | Individual |
| Provider Name | Angie Ison MS, RDN, LRD, CLC |
| Practice Office Address | 4430 MISSOURI AVE FORT LEONARD WO, MO US |
| Practice Office Telephone | 5735969093 |
| Mailing Address | 4430 MISSOURI AVE FORT LEONARD WOOD, MO 654739098 US |
| Business Telephone | 5935969093 |
| Code | Practice | License No State |
|---|---|---|
| 133V00000X PRIMARY | Dietary & Nutritional Service Providers Dietitian, Registered Dietitian, Registered All Other Specialties & Provider Types Dietitian, Registered Dietary & Nutritional Service Providers | 1564
ND |