Individual
MRS. SUSAN K. VANDERTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDE
Contact information
Practice address
2323 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 291-1143
(414) 291-1999
Mailing address
1010 N 122ND ST, WAUWATOSA, WI 53226-3312
(414) 259-1935
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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