Individual
TAMMY BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23 E ROSS AVE, SAPULPA, OK 74066-6423
(918) 216-4999
Mailing address
7514 W 80TH ST, #10, TULSA, OK 74131-3226
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0050320
OK
Other
Enumeration date
02/23/2017
Last updated
02/23/2017
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