SHANNON WISE

AUSTIN, TX
NPI1093258030
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: TX  DT81117)
Enumeration Date2016-11-23
Last Update Date2016-11-23
Business Address
-- SHANNON WISE RD, LD
2409 RIO MESA DR
AUSTIN, TX 78732-1964
Phone number: 415-260-8995
Mailing Address
-- SHANNON WISE RD, LD
2409 RIO MESA DRIVE
AUSTIN, TX 78732
Phone number: 415-260-8995
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