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1801309489
ALYSE C WAGNER
NEW ALBANY, IN
NPI
1801309489
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: IN 37002830A)
Enumeration Date
2017-11-06
Last Update Date
2017-11-06
Business Address
ALYSE C WAGNER RD
2125 STATE ST STE 1
NEW ALBANY, IN 47150-4987
Phone number: 812-949-7151
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Mailing Address
ALYSE C WAGNER RD
2700 STANLEY GAULT PKWY STE 129
LOUISVILLE, KY 40223-5176
Phone number: 812-273-5392
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