Most Relevant Information
Provider Data
| NPI Number: | 1003459009 |
| Provider Name: | SALLY W VAN CISE |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/22/2019 |
| Last Updated: | 10/22/2019 |
Provider Practice Location
2591 S LEATON RD
MT PLEASANT
MI
488588421
Practice Location Phone/Fax
| Phone: | 9897754615 |
| Fax: |
Provider Mailing Location
4089 W WING RD
MT PLEASANT
MI
488589585
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |