Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Functional Wellness LLC

Organization Registered Dietitian · NPI 1720783665

Functional Wellness LLC is a Registered Dietitian in Oklahoma City, Oklahoma. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1611 N Broadway Ave
Oklahoma City, OK 73103-4610
Phone: (405) 277-0144
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X

Record details

NPI number1720783665
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lori Mathews — Owner · (405) 277-0144
NPI enumeratedMarch 31, 2023
Last updated in NPPESMarch 31, 2023
Certification dateMarch 31, 2023
Mailing address1 Ne 2nd St Apt 401, Oklahoma City, OK 73104-2236

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