Most Relevant Information
Provider Data
| NPI Number: | 1003073842 |
| Provider Name: | LISA ANN WYLIE R.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 133VN1005X |
| Specialty: | Dietitian, Registered |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/20/2008 |
| Last Updated: | 05/20/2008 |
Provider Practice Location
300 E WARWICK DR
ALMA
MI
488011014
Practice Location Phone/Fax
| Phone: | 9894663330 |
| Fax: | 9894632540 |
Provider Mailing Location
PO BOX 188
ALMA
MI
488010188
Provider Mailing Phone/Fax
| Phone: | 9894663349 |
| Fax: | 9894667454 |