Individual
MRS. WENDY S BALISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
13111 NORTH PORT WASHINGTON RD, MEQUON, WV 53097
(262) 243-7376
Mailing address
W156N6406 WILDFLOWER DRIVE, MENOMONEE FALLS, WI 53051
(262) 703-0009
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
727508
WI
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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