Individual
LYNN MARIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
10500 N. STRATFORD PLACE, MEQUON, WI 53092-5553
(262) 242-7808
Mailing address
10500 N. STRATFORD PLACE, MEQUON, WI 53092-5553
(262) 242-7808
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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