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General NPI Number Information
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NPI Number | 1033361274
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Entity Type | Organization
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Legal Business Name | AMY PULS, RD, LD, LLC
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 619 S QUINCY AVE
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City | TULSA
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State | OK
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Zip | 74120-4621
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Country | US
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Telephone | 918-430-5616
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Fax |
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Provider Business Mailing Address
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Address Line | 6510 E 97TH ST
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City | TULSA
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State | OK
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Zip | 74133-5902
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Country | US
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Telephone | 918-430-5616
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Fax |
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Authorized Official
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Title or Position | REGISTERED AND LICENSED DIETITIAN
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Name | MRS. AMY JO PULS
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Credential | R.D., L.D.
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Telephone | 918-430-5616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State | OK
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