Individual
GARRETT CARTER CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(918) 207-9446
Mailing address
12360 E 13TH PL, TULSA, OK 74128-5237
(918) 441-3243
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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