MINDY LEE WALLACE

QUINCY, IL
NPI1851305304
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: IL  164003636)
Additional Taxonomies133V00000X Dietitian, Registered
(Licence: MO  2005004105)
Enumeration Date2006-07-28
Last Update Date2008-09-22
Business Address
Ms. MINDY LEE WALLACE RD LDN
935 JERSEY ST
QUINCY, IL 62301-4030
Phone number: 217-228-2413
Mailing Address
Ms. MINDY LEE WALLACE RD LDN
2820 E BLUFF CT
QUINCY, IL 62305-1329
Phone number: 217-440-6458