| |
263 Vietnam Veterans Memorial Highway, Mangilao, GU 96913 | |
(671) 735-8000 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Dietitian, Registered |
Location | 263 Vietnam Veterans Memorial Highway, Mangilao, Guam |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336633643 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 217954, Barrigada, GU 96921-6957 Ph: () - | 263 Vietnam Veterans Memorial Highway, Mangilao, GU 96913 Ph: (671) 735-8000 |
Jolan Su Mcninch, RD,LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3108 Greenpark Condo, Washington Drive, Mangilao, GU 96923 Phone: 671-487-7206 |