Most Relevant Information
Provider Data
| NPI Number: | 1003490152 |
| Provider Name: | MICHELLE TILLINGER RD, LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 2570 |
Most Important Dates
| Enumeration Date: | 05/05/2021 |
| Last Updated: | 05/05/2021 |
Provider Practice Location
4300 W MEMORIAL RD
OKLAHOMA CITY
OK
731208304
Practice Location Phone/Fax
| Phone: | 4058530128 |
| Fax: |
Provider Mailing Location
14890 GILBERT ST
CHOCTAW
OK
730208684
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |