Individual
LEE A HYRKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD,CD
Contact information
Practice address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4700
(920) 430-4747
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2667-29
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86014095
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
10/09/2014
Last updated
09/25/2019
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