Individual
MIRIAM LOOMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1338 PHAY AVE, CANON CITY, CO 81212-2311
(719) 285-2548
Mailing address
1338 PHAY AVE, CANON CITY, CO 81212-2311
(719) 285-2548
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86065749
CO
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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