Individual
EVELYN CLAIRE WILTSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
801 POLE LINE RD W RM H1155, TWIN FALLS, ID 83301-5810
(208) 814-1016
(208) 814-7212
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1581
ID
Other
Enumeration date
02/21/2024
Last updated
05/03/2024
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