Individual
KAREN SUE TAIT I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.T. (DIETETIC TECH)
Contact information
Practice address
434 W RIVER FRONT DR, GLENDALE, WI 53217-4459
(414) 881-1206
Mailing address
434 W RIVER FRONT DR, GLENDALE, WI 53217-4459
(414) 962-8881
(414) 962-8881
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
WI
Other
Enumeration date
06/28/2010
Last updated
06/28/2010
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