Individual
GEORGIA M. BANTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
1610 W UNIVERSITY BLVD, DURANT, OK 74701-3045
(580) 924-3400
(580) 924-7732
Mailing address
1610 UNIVERSITY BLVD, DURANT, OK 74701
(580) 924-3400
(580) 924-7732
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
725372
OK
133V00000X
Registered Dietitian
733
OK
Other
Enumeration date
08/21/2006
Last updated
04/12/2026
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