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General NPI Number Information
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NPI Number | 1093927170
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Entity Type | Organization
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Legal Business Name | NUTRITION CONSULTANTS OF TULSA, LLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 4157 S HARVARD AVE STE 109
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City | TULSA
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State | OK
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Zip | 74135-2606
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Country | US
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Telephone | 918-749-9077
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Fax | 918-749-4041
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Provider Business Mailing Address
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Address Line | 4157 S HARVARD AVE STE 109
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City | TULSA
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State | OK
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Zip | 74135-2606
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Country | US
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Telephone | 918-749-9077
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Fax | 918-749-4041
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Authorized Official
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Title or Position | OWNER
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Name | CONNIE DAVIS BENDEL
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Credential | RD, LD
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Telephone | 918-749-9077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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