Individual
MRS. LISA MARIE MCCLINTOCK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1898 FORT RD, SHERIDAN, WY 82801-8320
(307) 672-3473
Mailing address
1839 DE SMET AVE, SHERIDAN, WY 82801-5919
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
916725
—
Other
Enumeration date
06/11/2006
Last updated
07/08/2007
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