Organization
MARISSA CAMPBELL RD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA CAMPBELL RD (REGISTERED DIETITIAN)
(719) 246-6948
Entity
Organization
Contact information
Practice address
1832 WOODMOOR DR. SUITE 100, MONUMENT, CO 80132
(719) 246-6948
Mailing address
1832 WOODMOOR DR. SUITE 100, MONUMENT, CO 80132
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86066443
CDR NUMBER
—
Enumeration date
01/29/2022
Last updated
01/29/2022
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