Individual
MRS. ALYSSA CREWS BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 502-3939
Mailing address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 502-3939
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2564
OK
Other
Enumeration date
03/26/2009
Last updated
06/13/2017
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