| Doctor Name: | MRS. LYSANDRA VANDER HART |
| NPI Number: | 1659386514 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D. |
| License Number: | 945076 |
| Business Practice Address: | 311 State Street Grand Rapids, MI - 49503 |
| Business Phone Number: | 6162490159 |
| Business Fax Number: | 6162498688 |
| Mailing Address: | 6941 Cimarron Dr Se, GRAND RAPIDS |
| State: | MI |
| Postal Code: | 49546 |
| Phone Number: | 6162620617 |
| Fax Number: | |
| NPI Enumeration Date: | 07/29/2006 |
| NPI Last Update Date: | 02/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 945076 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |