Individual
MRS. JAN L TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LD
Contact information
Practice address
400 N LOOP 1604 E, SUITE 175, SAN ANTONIO, TX 78232-1258
(210) 545-4422
(210) 545-4495
Mailing address
30063 CLOUD VIEW DR, BULVERDE, TX 78163-4031
(210) 545-4422
(210) 545-4495
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT04462
TX
Other
Enumeration date
05/02/2008
Last updated
05/02/2008
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