| NPI | 1861868259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY SUE HICKS Dietitian 405-606-1086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: OK LD2080) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |