| NPI | 1720515562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREANNA RENE DALE Dietitian 918-224-9310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OK 2157) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |