Most Relevant Information
Provider Data
| NPI Number: | 1003060062 |
| Provider Name: | ELIZABETH S SQUIRES STAPLEY RD,LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 1616 |
Most Important Dates
| Enumeration Date: | 11/04/2008 |
| Last Updated: | 12/01/2008 |
Provider Practice Location
901 N PORTER AVE
NORMAN
OK
730716404
Practice Location Phone/Fax
| Phone: | 8018915091 |
| Fax: |
Provider Mailing Location
1203 REBECCA LN #218
NORMAN
OK
73072
Provider Mailing Phone/Fax
| Phone: | 8018915091 |
| Fax: |