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Individual

MALLORY CRUTCHFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD/LD

Contact information

Practice address
8801 S 101ST EAST AVE, TULSA, OK 74133-5716
(918) 294-4070
Mailing address
8735 E 46TH PL, TULSA, OK 74145-7101
(918) 728-1535

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1821319278
OK

Other

Enumeration date
03/20/2017
Last updated
03/20/2017
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