MEDICARE: BOK ENTERPRISES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1538725676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOK ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	1420 4TH AVE STE 30
Second Line	:
City	:	CANYON
State	:	TX
Zip	:	79015-3700
Country	:	US
Telephone Number	:	806-656-5055
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 4TH AVE STE 30
Second Line	:
City	:	CANYON
State	:	TX
Zip	:	79015-3700
Country	:	US
Telephone Number	:	806-656-5055
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JENNIFER M LEHESKA
Credential	:	PHD, RD, LD
Telephone Number	:	806-656-5055

Provider Enumeration Date	:	05/14/2019
Last Update Date	:	05/14/2019

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Directions to “BOK ENTERPRISES LLC ” Practice Location

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