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NPI Code Detail

MEDICARE: MRS. LEAH GRACE SCHOCK RDN

MEDICARE:  MRS. LEAH GRACE SCHOCK  RDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian86331741

General Provider Information

NPI Number : 1730996901
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LEAH GRACE SCHOCK RDN
Provider Business Mailing Address
First Line : 557 N 17TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53233-2718
Country : US
Telephone Number : 269-339-9825
Fax Number :
Provider Business Practice Location Address
First Line : 557 N 17TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53233-2718
Country : US
Telephone Number : 269-339-9825
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2024
Last Update Date : 12/11/2024

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Directions to “ MRS. LEAH GRACE SCHOCK RDN” Practice Location

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