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Individual

MARY SUSAN MARCUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
600 HIGHLAND AVE, COMPLIANCE MC 2433, MADISON, WI 53792-0001
(608) 662-0817
(608) 206-4544
Mailing address
600 HIGHLAND AVE, COMPLIANCE MC 2433, MADISON, WI 53792-0001
(608) 662-0817
(608) 206-4544

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
720417
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
483-29
CERTIFIED DIETITIAN
Enumeration date
01/20/2010
Last updated
01/20/2010
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