Individual
KARLIE GRACE WELLNITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CD
Contact information
Practice address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5011
Mailing address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5011
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2253-029
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1018644
COMMISSION ON DIETETIC REGISTRATION
WI
Enumeration date
11/03/2010
Last updated
03/05/2011
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