Individual
DESHAUN LAMAR MOOTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 W 36TH ST N, TULSA, OK 74106-1700
(918) 425-4200
Mailing address
1 W 36TH ST N, TULSA, OK 74106-1700
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/19/2019
Last updated
11/10/2020
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