Individual
TARA L. SPISAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
433 W HIGH ST, BRYAN, OH 43506-1690
(419) 630-2167
Mailing address
433 W HIGH ST, BRYAN, OH 43506-1690
(419) 630-2167
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L4906
OH
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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