Provider Demographics
NPI:1306932850
Name:RISMA, SUZANNE YVETTE (RD)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:YVETTE
Last Name:RISMA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2540 W 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3130
Mailing Address - Country:US
Mailing Address - Phone:303-465-0158
Mailing Address - Fax:303-465-0158
Practice Address - Street 1:FITNESS & HEALTH CENTER
Practice Address - Street 2:17890 E. STEAMBOAT AVE BLDG #35
Practice Address - City:BUCKLEY AFB
Practice Address - State:CO
Practice Address - Zip Code:80011-9547
Practice Address - Country:US
Practice Address - Phone:720-847-5699
Practice Address - Fax:720-847-6436
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered