Provider Demographics
NPI:1811669021
Name:KALBFLEISCH, LISA (RD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:KALBFLEISCH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5095 HASSLICK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48461-8524
Mailing Address - Country:US
Mailing Address - Phone:810-728-8769
Mailing Address - Fax:
Practice Address - Street 1:6140 RASHELLE DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3936
Practice Address - Country:US
Practice Address - Phone:810-262-2330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered