Individual
LARRY STANBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD,LD, CDE
Contact information
Practice address
1201 HEALTH CENTER PKWY, YUKON, OK 73099-6381
(405) 717-6800
(405) 717-5368
Mailing address
1201 HEALTH CENTER PKWY, YUKON, OK 73099-6381
(405) 717-6800
(405) 717-5368
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
769
OK
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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