Individual
MS. AMY S. VANDERWIELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,CD
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-3205
(920) 288-3201
Mailing address
530 VAN BUREN ST, LITTLE CHUTE, WI 54140-1921
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1866029
WI
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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