Individual
MALLORY C MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
7500 FRANCE AVE S, EDINA, MN 55435-3400
(952) 835-1311
Mailing address
800 E 28TH ST, MAIL ROUTE 11117, MINNEAPOLIS, MN 55407-3723
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2722
MN
Other
Enumeration date
08/12/2013
Last updated
08/12/2013
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