Individual
MISS ANGELA MARIE WALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D.N, L.D.N.
Contact information
Practice address
4515 POPLAR AVE STE 303, MEMPHIS, TN 38117-7507
(330) 495-6402
(901) 761-5933
Mailing address
2164 NELSON AVE, MEMPHIS, TN 38104-5760
(330) 495-6402
(901) 761-5933
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDN0000002149
TN
Other
Enumeration date
04/20/2010
Last updated
12/18/2016
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