Individual
KARLA MUSSEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4507 S ASH AVE, BROKEN ARROW, OK 74011-3600
(918) 605-0290
Mailing address
4507 S ASH AVE, BROKEN ARROW, OK 74011-3600
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1519
OK
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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