Individual
MS. BANDY JO RACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
5110 W GORE BLVD, LAWTON, OK 73505-5909
(580) 713-3123
Mailing address
PO BOX 485, MEDICINE PARK, OK 73557-0485
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
03/15/2006
Last updated
07/22/2022
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