Individual
LANE BAUMBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(800) 236-4101
Mailing address
3617 E GLORY LN APT 10, APPLETON, WI 54913-8102
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86152243
WI
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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