Individual
GRACEN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4008 S YALE AVE, TULSA, OK 74135-6017
(918) 622-4278
Mailing address
11314 S COLLEGE AVE, TULSA, OK 74137-8728
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
03/13/2024
Last updated
03/13/2024
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