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Individual

MICHAEL JAMES O'HALLORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LD

Contact information

Practice address
25 CONLEY RD, COLUMBIA, MO 65201-6477
(573) 442-7703
Mailing address
54 BROADWAY VILLAGE DR APT D, COLUMBIA, MO 65201-2107
(815) 671-0622

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2018029738
MO

Other

Enumeration date
08/27/2018
Last updated
08/27/2018
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