Individual
PAM JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
(405) 789-0690
Mailing address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
(405) 789-0690
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1104
OK
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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