Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Aug 17, 2009
License(s)
27255 (OK)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1705 E 19TH ST STE 600 | Tulsa, OK 74104-5417 | 918-872-6880 |
| MAILING | 1705E 19TH ST 302 | Tulsa, OK 74104-5410 | 918-748-7585 |
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