Most Relevant Information
Provider Data
| NPI Number: | 1003180167 |
| Provider Name: | DEANNA GUM RD, LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 1722 |
Most Important Dates
| Enumeration Date: | 03/06/2012 |
| Last Updated: | 03/06/2012 |
Provider Practice Location
115 W 3RD ST
SUITE 800
TULSA
OK
741033410
Practice Location Phone/Fax
| Phone: | 9185853045 |
| Fax: | 9185853047 |
Provider Mailing Location
115 W 3RD ST
SUITE 800
TULSA
OK
741033410
Provider Mailing Phone/Fax
| Phone: | 9185853045 |
| Fax: | 9185853047 |