Organization
NUTRITION SPECIALISTS OF NORTHEASTERN OKLAHOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY LYNN PRENTICE RDN (OWNER)
(918) 272-4207
Entity
Organization
Contact information
Practice address
10105 N BRIDGEWATER CIR, OWASSO, OK 74055-7727
(918) 272-4207
(866) 296-1005
Mailing address
10105 N BRIDGEWATER CIR, OWASSO, OK 74055-7727
(918) 272-4207
(866) 296-1005
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1488
OK
Other
Enumeration date
03/04/2015
Last updated
04/12/2018
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