NPI 1124327267

Gary Bradford

Practitioner Dietary Manager Muskogee, OK

Practice location

Address: 928 N York St Suite 20, Muskogee, OK 74403-3123
Phone: (918) 913-9109
Fax: (918) 913-9112

Registered specialties

Dietary Manager Primary

Dietary & Nutritional Service Providers Taxonomy 132700000X

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Registry record

NPI: 1124327267
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Mar 2011
Record last updated: 14 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.