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1477943652
KAELY JACKSON
OKLAHOMA CITY, OK
NPI
1477943652
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: OK 1961)
Enumeration Date
2015-01-27
Last Update Date
2015-01-27
Business Address
-- KAELY JACKSON RD/LD
1200 CHILDRENS AVE SUITE 1A
OKLAHOMA CITY, OK 73104-4637
Phone number: 405-271-5400
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Mailing Address
-- KAELY JACKSON RD/LD
1200 CHILDRENS AVE SUITE 1A
OKLAHOMA CITY, OK 73104-4637
Phone number: 405-271-5400
Copy
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