Individual
MS. TORIE ANN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
2307 GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 395-9303
(405) 395-9305
Mailing address
2307 GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 395-9303
(405) 395-9305
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
669
OK
Other
Enumeration date
08/30/2013
Last updated
09/03/2013
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