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1720267651
TRACIE KENNON MATHIS
TULSA, OK
NPI
1720267651
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: OK LD932)
Enumeration Date
2007-10-27
Last Update Date
2022-01-26
Business Address
TRACIE KENNON MATHIS RD/LD IBCLC
6161 S YALE AVE
TULSA, OK 74136-1902
Phone number: 918-230-6409
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Mailing Address
TRACIE KENNON MATHIS RD/LD IBCLC
8710 S 71ST EAST AVE
TULSA, OK 74133-5053
Phone number: 918-494-6455
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