Individual
KELLY GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 HEALTH CENTER PKWY, YUKON, OK 73099-6381
(405) 717-5350
Mailing address
115 W 3RD ST STE 800, TULSA, OK 74103-3421
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1255
OK
Other
Enumeration date
12/06/2006
Last updated
05/23/2022
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