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Individual

TREY RYAN ROUNDTREE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN-CRNA

Contact information

Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 223-5400
Mailing address
729 DOLESE RD, ARDMORE, OK 73401-7578
(580) 513-4732

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
99885
OK

Other

Enumeration date
01/25/2018
Last updated
03/17/2018
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