Individual
EVAN WAYNE SHETLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(918) 561-8257
Mailing address
2825 E 26TH ST, TULSA, OK 74114-4419
(573) 259-7805
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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