Individual
MICHELE RENEE WALLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CD
Contact information
Practice address
1700 E 38TH ST, MARION, IN 46953-4568
(765) 674-3321
(765) 677-3150
Mailing address
9347 W. CO. RD. 50 S., FARMLAND, IN 47340
(765) 468-7170
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
706346
IN
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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