Ellen A Sushak, RD

NPI #1609090521 in West Bend, Wisconsin

Provider Information

NPI Number: 1609090521
Entity Type: Individual
Name: Ellen A Sushak, RD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dietitian, Registered
Credential: RD
Enumeration Date: Apr 12, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 205 VALLEY AVE
City: West Bend
State: Wisconsin
ZIP Code: 53095-5312
Phone: (262) 338-1123

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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