Locklear, Liza Jo

Locklear, Liza Jo is an individual health care provider with primary practice located at 2641 Development Dr , Green Bay WI 54311-4240. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Locklear, Liza Jo can be contacted via phone (920) 338-6868.

Contact Information

Primary practice address
2641 Development Dr Green Bay WI 54311-4240
Phone: (920) 338-6868
Fax: (920) 338-6869
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 1610-29 Wisconsin

Profile Details

NPI number 1932388212
LBN Legal business name Locklear, Liza Jo
Credentials RD CD CDE
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2007
Last updated Feb 10th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932388212 NPPES
Other 886243 COMMISSION ON DIETETIC REGISTRATION
Other 21900466 COMMISSION ON DIETETIC REGISTRATION

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