Provider Demographics
NPI:1972387074
Name:MALAN, CLOIE (RD)
Entity Type:Individual
Prefix:
First Name:CLOIE
Middle Name:
Last Name:MALAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2274 W PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-8805
Mailing Address - Country:US
Mailing Address - Phone:385-205-7779
Mailing Address - Fax:
Practice Address - Street 1:2274 W PIONEER RD
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-8805
Practice Address - Country:US
Practice Address - Phone:385-205-7779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered