Most Relevant Information
Provider Data
| NPI Number: | 1003404740 |
| Provider Name: | LISA MARIE HERZBERG RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 86156828 |
Most Important Dates
| Enumeration Date: | 01/07/2021 |
| Last Updated: | 11/22/2021 |
Provider Practice Location
2301 N LAKE DR
MILWAUKEE
WI
532114508
Practice Location Phone/Fax
| Phone: | 4142911316 |
| Fax: |
Provider Mailing Location
2301 N LAKE DR
MILWAUKEE
WI
532114508
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |