Individual
MRS. MOLLY TYNER SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
600 S MONROE ST, ENID, OK 73701-7211
(580) 548-1370
(580) 233-8802
Mailing address
PO BOX 3168, ENID, OK 73702-3168
(580) 548-1370
(580) 233-8802
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD1065
OK
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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