Individual
MRS. LYSANDRA VANDER HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
311 STATE STREET, GRAND RAPIDS, MI 49503
(616) 249-0159
(616) 249-8688
Mailing address
6941 CIMARRON DR SE, GRAND RAPIDS, MI 49546
(616) 262-0617
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
945076
—
Other
Enumeration date
07/29/2006
Last updated
02/03/2015
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