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Organization

THE MOTHER ROAD DIETITIAN, LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRYSTAL DUNHAM RDN, LD (REGISTERED DIETITIAN NUTRITIONIST)
(918) 539-0678
Entity
Organization

Contact information

Practice address
8211 E REGAL PL STE 100, TULSA, OK 74133-7181
(918) 539-0678
(918) 273-6660
Mailing address
8211 EAST REGAL PLACE STE 100, PMB 704, TULSA, OK 74133-7214
(918) 539-0678
(918) 273-6660

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
09/18/2021
Last updated
09/11/2025
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