Most Relevant Information
Provider Data
| NPI Number: | 1003239559 |
| Provider Name: | LISHA M SMATHERS RD, LD, CNSC |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 1258 |
Most Important Dates
| Enumeration Date: | 02/03/2014 |
| Last Updated: | 02/03/2014 |
Provider Practice Location
9353 SW 21ST ST
OKLAHOMA CITY
OK
731284928
Practice Location Phone/Fax
| Phone: | 4056275650 |
| Fax: |
Provider Mailing Location
9353 SW 21ST ST
OKLAHOMA CITY
OK
731284928
Provider Mailing Phone/Fax
| Phone: | 4056275650 |
| Fax: |