Individual
TANYA FORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4134 E 31ST ST, TULSA, OK 74135-1511
(918) 346-6617
Mailing address
4134 E 31ST ST, TULSA, OK 74135-1511
(918) 346-6617
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1946
OK
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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