Shawn Idell, RD, LD

NPI #1942654819 in Durant, Oklahoma

Provider Information

NPI Number: 1942654819
Entity Type: Individual
Name: Shawn Idell, RD, LD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dietitian, Registered
Credential: RD, LD
Enumeration Date: Apr 18, 2016
Last Updated: Apr 18, 2016

Practice Location

Address: 1800 W UNIVERSITY BLVD
City: Durant
State: Oklahoma
ZIP Code: 74701-3006
Phone: (580) 924-3080

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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