Individual
BARBARA J MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2220 E 25TH ST, IDAHO FALLS, ID 83404-7542
(208) 523-1122
(208) 523-2582
Mailing address
2220 E 25TH ST, IDAHO FALLS, ID 83404-7542
(208) 523-1122
(208) 523-2582
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
D311
ID
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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