Individual
KELLY M GRANDLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
W292N7503 DORN RD, HARTLAND, WI 53029-9247
(608) 228-6223
Mailing address
W292N7503 DORN RD, HARTLAND, WI 53029-9247
(608) 228-6223
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86329415
WI
Other
Enumeration date
04/17/2023
Last updated
10/12/2023
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