Most Relevant Information
Provider Data
| NPI Number: | 1003651969 |
| Provider Name: | JAMIKA ALISE SMITH RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | LD006354 |
Most Important Dates
| Enumeration Date: | 07/01/2024 |
| Last Updated: | 07/01/2024 |
Provider Practice Location
3501 E GORE BLVD APT 221
LAWTON
OK
735016849
Practice Location Phone/Fax
| Phone: | 8047042966 |
| Fax: |
Provider Mailing Location
3501 E GORE BLVD APT 221
LAWTON
OK
735016849
Provider Mailing Phone/Fax
| Phone: | 8047042966 |
| Fax: |