Individual
KASSANDRE S BALOCCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1265 S UTICA AVE, SUITE 300, TULSA, OK 74104-4243
(918) 592-0999
(918) 592-1021
Mailing address
1265 S UTICA AVE, SUITE 300, TULSA, OK 74104-4243
(918) 592-0999
(918) 592-1021
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2313
OK
Other
Enumeration date
01/14/2014
Last updated
12/01/2014
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