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Individual

MS. CHRISTIE LEA COGGBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LD,CSR

Contact information

Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3178
Mailing address
118 EUBANKS, TAHLEQUAH, OK 74464-8841
(918) 431-1515

Taxonomy

Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
LD982
OK

Other

Enumeration date
04/20/2007
Last updated
07/08/2007
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