SUSAN WALLACE, R,D., L.D.

Dietitian, Registered

Active Individual
NPI: 1376842732

Practice Address

102 CARRAN DR
Lakeside Park, KY 41017

Phone: (859) 331-2939

Specialties

Specialty Code Primary License
Dietitian, Registered 133V00000X Yes KY-1998 (KY)

Frequently Asked Questions

NPI 1376842732 is the National Provider Identifier for SUSAN WALLACE, R,D., L.D., a Dietitian, Registered provider located in Lakeside Park, KY. This NPI was enumerated on March 23, 2011.
SUSAN WALLACE, R,D., L.D. practices at 102 CARRAN DR, Lakeside Park, KY 41017.

Quick Facts

NPI
1376842732
Type
Individual
Enumerated
Mar 23, 2011
Last Updated
Mar 23, 2011

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