Individual
BRIAN H VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17675 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-5492
(918) 453-5555
Mailing address
17675 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-5492
(918) 453-5555
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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