Individual
MRS. SUSAN MARIE WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
200 SAINT CLAIR AVE, SAINT MARYS, OH 45885-2400
(419) 394-3335
Mailing address
200 SAINT CLAIR AVE, SAINT MARYS, OH 45885-2400
(419) 394-3335
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4435
OH
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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