Individual
MRS. ELISE ROSE COOPER-HORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
301 S. JT STITES, SALLISAW, OK 74955
(918) 775-9150
Mailing address
473425 E 1127 RD, MULDROW, OK 74948
(918) 427-7525
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
551
AR
Other
Enumeration date
10/04/2006
Last updated
01/19/2017
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