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MS. LISA MALLOY R.D.

>> Dietitian, Registered >> Dietary & Nutritional Service Providers

Registrant NPI Number: 1962537522

Individual Registrant:
MS. LISA  MALLOY R.D.
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

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

Registration Information:
NPI: 1962537522
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y133V00000XDietary & Nutritional Service Providers
Dietitian, Registered
CO810059

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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