| NPI | 1528564929 |
|---|---|
| Doing Business As | SJC OUTPATIENT DIABETES CENTER |
| Entity Type | Organization |
| Authorized Contact | JAMES BRYAN FISSEL Director Chief Financial Officer 918-748-7617 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 163WD0400X Registered Nurse, Diabetes Educator | |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |