Individual
JERRY MOYNIHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4028 W 42ND ST, TULSA, OK 74107-6326
(512) 571-3286
Mailing address
4028 W 42ND ST, TULSA, OK 74107-6326
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
J081120129
OK
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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