Individual
MRS. KIRA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 742-4131
Mailing address
882 MCMILLAN RD, POYNETTE, WI 53955-9227
(608) 265-0963
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
850777
WI
Other
Enumeration date
07/30/2007
Last updated
02/17/2015
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