Individual
MRS. TABITHA JOANNE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
301 J T STITES BLVD, SALLISAW, OK 74955-9302
(918) 774-1492
(918) 774-1425
Mailing address
301 J T STITES BLVD, SALLISAW, OK 74955-9302
(918) 774-1492
(918) 774-1425
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1584
OK
Other
Enumeration date
03/12/2008
Last updated
03/12/2008
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