Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 1605 | WI |
NPI | 1154674794 |
---|---|
Provider Name | Dr. David William Bitter |
First Address | Wisconsin Rapids, WI 54494-5701 |
Second Address | Wisconsin Rapids, WI 54494-5701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2012 |
Last Update Date | 19/10/2012 |