Individual
MRS. SANDRA D GIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D. L.D.
Contact information
Practice address
1900 N 14TH ST, PONCA CITY, OK 74601-2035
(580) 765-0572
Mailing address
1900 N 14TH ST, PONCA CITY, OK 74601-2035
(580) 765-0269
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1474
OK
133V00000X
Registered Dietitian
—
IL
Other
Enumeration date
12/03/2007
Last updated
04/10/2009
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