Most Relevant Information
Provider Data
| NPI Number: | 1003030966 |
| Provider Name: | HALEY KOUBA R.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/12/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1301 SUMMIT ST
MARSHALLTOWN
IA
501585484
Practice Location Phone/Fax
| Phone: | 6417534518 |
| Fax: |
Provider Mailing Location
1301 SUMMIT ST
MARSHALLTOWN
IA
501585484
Provider Mailing Phone/Fax
| Phone: | 6417534518 |
| Fax: |