Individual
MARY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
3400 W TECUMSEH RD, NORMAN, OK 73072-1810
(405) 360-7100
Mailing address
2208 RIDGEWOOD DR, MOORE, OK 73160-4229
(405) 819-5038
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1657
OK
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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