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1891819769
SAMANTHA JEAN MALLOY
MINNEAPOLIS, MN
NPI
1891819769
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Former Name
SAMANTHA JEAN TOLLEFSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: MN 2444)
Enumeration Date
2007-03-18
Last Update Date
2011-05-03
Business Address
-- SAMANTHA JEAN MALLOY RD, LD
1 VETERANS DR
MINNEAPOLIS, MN 55417-2309
Phone number: 612-467-4374
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Mailing Address
-- SAMANTHA JEAN MALLOY RD, LD
12130 YUKON AVE N
CHAMPLIN, MN 55316-3582
Phone number: 612-618-6724
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