Individual
MRS. KATHERINE J WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NATUROPATH
Contact information
Practice address
675 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 257-9700
Mailing address
675 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 257-9700
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
175F00000X
Naturopath
Primary
—
—
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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