NPI 1174543854

Timothy Ballweg, RT

Practitioner Dietary Manager Madison, WI

Practice location

Address: 675 W Washington Ave, Madison, WI 53703-2637
Phone: (608) 257-9700
Mailing address: 1265 John Q Hammons Dr, Madison, WI 53717-1941

Registered specialties

Dietary Manager Primary

Dietary & Nutritional Service Providers Taxonomy 132700000X Licence 1647 (WI)

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Registry record

NPI: 1174543854
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Jul 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.