| Mr Larry William Immenschuh, RDLD | |
|
3009 N. W. Wilson Street, Fort Sill, OK 73503-9042 | |
| (580) 458-2134 | |
| (580) 458-2314 |
| Full Name | Mr Larry William Immenschuh |
|---|---|
| Gender | Male |
| Speciality | Dietitian, Registered |
| Location | 3009 N. W. Wilson Street, Fort Sill, Oklahoma |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699914168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 630 (Oklahoma) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Larry William Immenschuh, RDLD 1406 Ne Independence Ave, Lawton, OK 73507-3438 Ph: (580) 695-3213 | Mr Larry William Immenschuh, RDLD 3009 N. W. Wilson Street, Fort Sill, OK 73503-9042 Ph: (580) 458-2134 |
Ms. Sawanya Janthachotikun, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4301 Wilson St, Fort Sill, OK 73503 Phone: 805-558-2823 | |
Amy Rae See, RD/LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4301 Mow-way Road, Fort Sill, OK 73503 Phone: 580-458-2823 | |
Ms. Brenda D Bustillos, MS, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4301 Mow-way Road (mcua-ncd), Cdr Usameddac, Fort Sill, OK 73503 Phone: 580-458-3055 Fax: 580-458-2846 |