Individual
MR. RICKEY D BRUNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11428 E 20TH ST, TULSA, OK 74128-6451
(918) 878-7877
Mailing address
2712 N DENVER AVE, TULSA, OK 74106-2222
(918) 853-2448
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/30/2012
Last updated
05/07/2014
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