Individual
JOLAN SU MCNINCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
3108 GREENPARK CONDO, WASHINGTON DRIVE, MANGILAO, GU 96923-9692
(671) 487-7206
Mailing address
PO BOX 5224, MANGILAO, GU 96923-5224
(671) 487-7206
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
05
GU
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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