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MS. LISA MALLOY R.D.
>> Dietitian, Registered >> Dietary & Nutritional Service ProvidersRegistrant NPI Number: 1962537522
Individual Registrant:MS. LISA MALLOY R.D.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
23500 US HIGHWAY 160 SPANISH PEAKS REGIONAL HEALTH CENTER WALSENBURG, CO 81089-9524 US
Tel: 719-738-5100 Fax: 719-738-5138
Tel: 719-738-5100 Fax: 719-738-5138
Contact information for business:
23500 US HIGHWAY 160 SPANISH PEAKS REGIONAL HEALTH CENTER WALSENBURG, CO 81089-9524 US
Tel: 719-738-5100 Fax: 719-738-5138
Tel: 719-738-5100 Fax: 719-738-5138
Registration Information:
NPI: 1962537522
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 133V00000X | Dietary & Nutritional Service Providers Dietitian, Registered | CO | 810059 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
