Individual
MARY RADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
611 N MAYFAIR RD, WAUWATOSA, WI 53226-4248
(414) 258-2255
Mailing address
611 N MAYFAIR RD, WAUWATOSA, WI 53226-4248
(414) 258-2255
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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