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Individual

MEGAN MARIE WALTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
600 HIGHLAND AVE # F4120, CLINICAL NUTRITION, MADISON, WI 53792-0001
(608) 263-8245
(608) 262-1636
Mailing address
600 HIGHLAND AVE # F4120, CLINICAL NUTRITION, MADISON, WI 53792-0001
(608) 263-8245
(608) 262-1636

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
878904

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1686-29
CERTIFIED DIETITIAN
WI
Enumeration date
01/26/2010
Last updated
02/03/2010
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