Individual
DEMETRIUS TERRY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4106 S 130TH EAST PL, TULSA, OK 74134
(918) 230-9789
Mailing address
4106 S 130TH EAST PL, TULSA, OK 74134-1134
(918) 230-9789
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
Z309380073
OK
Other
Enumeration date
03/31/2026
Last updated
03/31/2026
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