Individual
MRS. CHARLENE ANN BURIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD CD IBCLC
Contact information
Practice address
3213 TWISTED BRANCH PL, FORT WAYNE, IN 46804-3436
(260) 436-3980
Mailing address
3213 TWISTED BRANCH PL, FORT WAYNE, IN 46804-3436
(260) 436-3980
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001225A
IN
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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