Individual
SALLY W VAN CISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2591 S LEATON RD, MT PLEASANT, MI 48858-8421
(989) 775-4615
Mailing address
4089 W WING RD, MT PLEASANT, MI 48858-9585
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
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