Individual
ODESSA M GALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDCD
Contact information
Practice address
143 SOUTH GIBSON STREET, MEDFORD, WI 54451-1622
(715) 748-2121
(715) 748-7590
Mailing address
143 SOUTH GIBSON STREET, MEDFORD, WI 54451-1622
(715) 748-2121
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1752
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100531
SECURITY HEALTH PLAN
WI
Enumeration date
08/11/2006
Last updated
10/13/2015
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