Individual
JULIE FREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN/LDN
Contact information
Practice address
715 GRANDVIEW AVE, PAWHUSKA, OK 74056-3201
(918) 287-5525
Mailing address
3200 E INDIAN RD, NEWKIRK, OK 74647-7340
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R080653797
DRIVER'S LICENSE
OK
Enumeration date
01/07/2019
Last updated
01/07/2019
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