Individual
JESSICA MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 N 500 E, LOGAN, UT 84341-2455
(435) 716-1000
Mailing address
1400 N 500 E, LOGAN, UT 84341-2455
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86175825
UT
Other
Enumeration date
06/04/2022
Last updated
06/04/2022
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