Organization
PBA WELLNESS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH CHRISTINE MILLER RD/LD (DIETITIAN)
(918) 551-7901
Entity
Organization
Contact information
Practice address
4775 E 91ST ST, TULSA, OK 74137-2801
(918) 496-2000
(918) 496-2338
Mailing address
4775 E 91ST ST, TULSA, OK 74137-2801
(918) 496-2000
(918) 496-2338
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1678
OK
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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