Individual
JULIE REISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 557-5374
(719) 557-4100
Mailing address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 557-7374
(719) 557-4100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
225400000X
Rehabilitation Practitioner
917568
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
917568
DIETICIAN
CO
Enumeration date
06/07/2007
Last updated
01/30/2008
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