Individual
CARLY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(785) 224-8756
Mailing address
8019 W PARKWAY BLVD APT 102, TULSA, OK 74127-5649
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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