| NPI | 1982775904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY REBECCA MIKES Registered Dietitian 405-659-2805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OK 1107) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2010-03-15 |