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1104535012
TRAVIS COLTON EDEN
OWASSO, OK
NPI
1104535012
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: OK 2512)
Enumeration Date
2022-11-18
Last Update Date
2022-11-18
Business Address
TRAVIS COLTON EDEN RDN
10301 N 98TH EAST AVE
OWASSO, OK 74055-7883
Phone number: 479-787-0811
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Mailing Address
TRAVIS COLTON EDEN RDN
1819 E 19TH ST
TULSA, OK 74104-5407
Phone number: 918-744-3624
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