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Individual

STEPHEN ROBERT SEIFERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RD,CD

Contact information

Practice address
3415 CUSTER ST, MANITOWOC, WI 54220-4324
(920) 652-9310
(920) 652-9316
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3455-29
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86150257
COMMISSION ON DIETETIC REGISTRATION
Enumeration date
11/05/2019
Last updated
07/30/2020
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