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Organization

SUSAN L. DELAGRANGE

Active
Other names
Susan Delagrange Sole Mbr
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN LYNN DELAGRANGE MS., RD. (REGISTERED DIETITIAN)
(260) 433-3367
Entity
Organization

Contact information

Practice address
2607 BARRY KNOLL WAY, FORT WAYNE, IN 46845-1942
(260) 433-3367
(260) 637-5780
Mailing address
2607 BARRY KNOLL WAY, FORT WAYNE, IN 46845-1942
(260) 433-3367
(260) 637-5780

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
910521
IN

Other

Enumeration date
02/09/2010
Last updated
03/15/2010
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