Most Relevant Information
Provider Data
| NPI Number: | 1003211715 |
| Provider Name: | REBEKAH LEA MAXWELL RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 2017 |
Most Important Dates
| Enumeration Date: | 10/24/2014 |
| Last Updated: | 10/24/2014 |
Provider Practice Location
921 NE 13TH ST
OKLAHOMA CITY
OK
731045007
Practice Location Phone/Fax
| Phone: | 4054561000 |
| Fax: | 4054561695 |
Provider Mailing Location
1105 NW 7TH PL
MOORE
OK
731701207
Provider Mailing Phone/Fax
| Phone: | 4054561000 |
| Fax: | 4054561695 |