Individual
JILL ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
904 E KRAYLER AVE, STILLWATER, OK 74075-2918
(817) 480-2661
Mailing address
904 E KRAYLER AVE, STILLWATER, OK 74075-2918
(817) 480-2661
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2322
OK
Other
Enumeration date
08/04/2019
Last updated
08/04/2019
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