Individual
MS. TARA DIANE CONWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDLD
Contact information
Practice address
2222 W IOWA AVE, CHICKASHA, OK 73018-2738
(405) 224-8111
(405) 222-9561
Mailing address
2222 W IOWA AVE, CHICKASHA, OK 73018-2738
(405) 224-8111
(405) 222-9561
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1187
OK
Other
Enumeration date
05/24/2007
Last updated
02/05/2016
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