Individual
MARCIA D. TYNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.D.
Contact information
Practice address
1001 E 18TH ST, GROVE, OK 74344-2907
(918) 786-4461
(918) 787-3645
Mailing address
1001 E 18TH ST, GROVE, OK 74344-2907
(918) 786-4461
(918) 787-3645
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1428
OK
Other
Enumeration date
02/14/2011
Last updated
02/14/2011
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