Individual
DYANI SHORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(580) 579-9510
Mailing address
3775 SOUTHRIDGE CIR APT 9, TAHLEQUAH, OK 74464-7941
(580) 579-9510
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OK
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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