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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JEANNE M WALLACE, PHD

Active Sole Proprietor

JEANNE M WALLACE, PHD is a Nutritionist healthcare provider located in NORTH LOGAN, Utah. NPI 1285911032 is currently active in the NPPES registry. Verify at CMS.

Nutritionist · NORTH LOGAN, UT

Registration Details

NPI Number
1285911032
Provider Type
Individual
Gender
Female
NPI Issued
Nov 8, 2011 (14.785656152961 yrs)
Last Updated
Nov 8, 2011
Sole Proprietor
Yes

Practice Information

Address
1697 E 3450 N
NORTH LOGAN, UT, 843418310
Browse UT providers · Browse ZIP 84341
Phone
4355630053
Fax
4355388058
Primary Specialty
Nutritionist
133N00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.