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1518987486
MARLO WAGNER
TULSA, OK
NPI
1518987486
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: OK 809909)
Enumeration Date
2006-07-20
Last Update Date
2007-07-08
Business Address
Mrs. MARLO WAGNER RD,CDE
9322 E 41ST ST
TULSA, OK 74145-3721
Phone number: 918-764-7209
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Mailing Address
Mrs. MARLO WAGNER RD,CDE
5442 E 109TH PL
TULSA, OK 74137-7247
Phone number: 918-296-3910
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