Organization
CENTRAL FITT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY DAWN BUZAN RD, LD (REGISTERED DIETITIAN,VICE-PRESIDENT)
(405) 503-2759
Entity
Organization
Contact information
Practice address
2010 S BROADWAY, EDMOND, OK 73013-4019
(405) 503-2759
(405) 330-9921
Mailing address
2010 S BROADWAY, EDMOND, OK 73013-4019
(405) 503-2759
(405) 330-9921
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1530
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669651188
NPI--INDIVIDUAL
OK
Enumeration date
02/15/2008
Last updated
02/15/2008
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