Individual
LISA ANN HARDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D. L.D.
Contact information
Practice address
3910 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-2582
Mailing address
3910 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-2582
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-745
ID
Other
Enumeration date
02/15/2013
Last updated
03/13/2013
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