Individual
MIKE SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
2968 CONQUEST ST, FORT COLLINS, CO 80524-7517
(949) 521-4626
Mailing address
2968 CONQUEST ST, FORT COLLINS, CO 80524-7517
(949) 521-4626
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86210560
CO
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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