# FOUNDATION WEIGHTWISE SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WeightWise at Edmond
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316123912
- **Authorized official:** MR. ROBERT MORTON BYERS (PRESIDENT / COO)
- **Authorized official phone:** (405) 608-1700

## Contact information

- **Practice address:** 1800 RENAISSANCE BLVD, SECOND FLOOR, EDMOND, OK 73013-3023
- **Practice address phone:** (405) 359-2473
- **Practice address fax:** (405) 359-2499
- **Mailing address:** 1800 RENAISSANCE BLVD, SECOND FLOOR, EDMOND, OK 73013-3023
- **Mailing address phone:** (405) 359-2473
- **Mailing address fax:** (405) 359-2499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/14/2008
- **Last updated:** 01/14/2008