Individual
DIANA WALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MNT
Contact information
Practice address
122 JACKSON CIR, LOUISVILLE, CO 80027-1629
(401) 835-5687
Mailing address
122 JACKSON CIR, LOUISVILLE, CO 80027-1629
(401) 835-5687
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
10/02/2015
Last updated
10/02/2015
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