Individual
LANE E WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
1721 NE 34TH LN, CAPE CORAL, FL 33909-7356
(217) 714-0203
Mailing address
1721 NE 34TH LN, CAPE CORAL, FL 33909-7356
(217) 714-0203
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/01/2021
Last updated
08/01/2021
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