| NPI | 1003824079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARYN EVELYN MOEHRING Clinical Nutrition Therapist 608-836-3473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WI 1680-029) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: WI 52D1056475) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-08-22 |