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Individual

MYRA JILL OLIVAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
4701 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1219
(505) 727-7819
Mailing address
10823 MONTEREY BAY CT NW, ALBUQUERQUE, NM 87114-1998
(505) 792-1014

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-0564
NM

Other

Enumeration date
05/12/2008
Last updated
05/12/2008
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