SAMANTHA JEAN MALLOY

MINNEAPOLIS, MN
NPI1891819769
Former NameSAMANTHA JEAN TOLLEFSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: MN  2444)
Enumeration Date2007-03-18
Last Update Date2011-05-03
Business Address
-- SAMANTHA JEAN MALLOY RD, LD
1 VETERANS DR
MINNEAPOLIS, MN 55417-2309
Phone number: 612-467-4374
Mailing Address
-- SAMANTHA JEAN MALLOY RD, LD
12130 YUKON AVE N
CHAMPLIN, MN 55316-3582
Phone number: 612-618-6724