Susan Elizabeth Wallace, R,D., L.D.
NPI #1376842732 in Lakeside Park, Kentucky
Provider Information
- NPI Number
- 1376842732
- Entity Type
- Individual
- Name
- Susan Elizabeth Wallace, R,D., L.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dietitian, Registered
- Credential
- R,D., L.D.
- Enumeration Date
- Mar 23, 2011
- Last Updated
- Mar 23, 2011
Practice Location
- Address
- 102 CARRAN DR
- City
- Lakeside Park
- State
- Kentucky
- ZIP Code
- 41017-2233
- Phone
- (859) 331-2939
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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