Provider Demographics
NPI:1790924801
Name:GALLOWAY, JOY ELIZABETH (RD)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:ELIZABETH
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 WILSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1432
Mailing Address - Country:US
Mailing Address - Phone:580-467-2028
Mailing Address - Fax:
Practice Address - Street 1:1720 WILSHIRE DR
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1432
Practice Address - Country:US
Practice Address - Phone:580-467-2028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK608133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal