Individual
MS. ELLEN LOUISE GREEN-YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
670 PETUNIA ROAD, WRIGHT CITY, OK 74766
(580) 236-3705
(580) 981-7005
Mailing address
PO BOX 100, WRIGHT CITY, OK 74766-0100
(580) 236-3705
(580) 981-7005
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
879
OK
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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