Organization
LOVE NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA J TILLEY RD/LD (REGISTERED DIETITIAN)
(918) 497-9764
Entity
Organization
Contact information
Practice address
8505 N 129TH EAST AVE, OWASSO, OK 74055-7168
(918) 376-2529
(918) 376-2548
Mailing address
8505 N 129TH EAST AVE, OWASSO, OK 74055-7168
(918) 376-2529
(918) 376-2548
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD1042
OK
Other
Enumeration date
08/01/2012
Last updated
08/15/2012
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