Individual
DALLAS THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1007 S. MUSKOGEE ST., TAHLEQUAH, OK 74464
(417) 635-4304
Mailing address
710 EAST CHERRIE, TAHLEQUAH, OK 74464
(539) 297-8902
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
09/27/2025
Last updated
09/27/2025
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