Individual
JANE MILLAR MALLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5071
Mailing address
965 FLYING EAGLE PL, COLORADO SPRINGS, CO 80919-1601
(719) 533-0607
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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