Individual
ALEXANDRA PROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(405) 501-1062
Mailing address
3121 KENT DR, OKLAHOMA CITY, OK 73120-2230
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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