Individual
JODI LEE MASONCUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
149 HART ST, SHEPPARD AFB, TX 76311-3430
(940) 676-6003
Mailing address
1600 11TH ST, WICHITA FALLS, TX 76301-4300
(940) 764-3139
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT87504
TX
Other
Enumeration date
11/20/2023
Last updated
01/08/2025
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