Individual
MR. JASON S. MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD, LDN
Contact information
Practice address
1224 TROTWOOD AVE, COLUMBIA, TN 38401-4802
(931) 388-1111
(931) 540-4213
Mailing address
924 EVERYMAN CT, COLUMBIA, TN 38401-5596
(731) 571-0736
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD0000001968
TN
Other
Enumeration date
12/03/2008
Last updated
09/14/2009
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