Individual
MRS. KELLY STOVER BEALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D./ L.D.
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 270-0501
Mailing address
3220 ROCKHAMPTON AVE, OKLAHOMA CITY, OK 73179-1223
(405) 270-0501
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1076
OK
Other
Enumeration date
09/22/2006
Last updated
07/09/2007
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