Individual
MISS LISA M KOVALEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 BODIN CIR, TRAVIS AFB, CA 94535-1801
(916) 833-2525
Mailing address
276 HORNSBY CT, FOLSOM, CA 95630-8461
(919) 833-2525
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/10/2006
Last updated
12/05/2007
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