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General NPI Number Information
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NPI Number | 1871725978
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Entity Type | Organization
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Legal Business Name | NUTRITIONAL VOICES LLC
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Dates
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Enumeration Date | 08/22/2009
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Last Update Date | 02/12/2011
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Provider Practice Location Address
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Address Line | 21333 E 104TH ST
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City | BROKEN ARROW
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State | OK
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Zip | 74014-3669
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Country | US
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Telephone | 918-449-1123
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Fax |
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Provider Business Mailing Address
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Address Line | 21333 E 104TH ST
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City | BROKEN ARROW
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State | OK
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Zip | 74014-3669
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Country | US
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Telephone | 918-449-1123
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Fax |
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Authorized Official
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Title or Position | NUTRITION THERAPIST
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Name | ANDREA DAWN SHOTTON
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Credential | MS RD LD
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Telephone | 918-449-1123
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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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