Individual
AMBER BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1870 S BOULDER AVE, TULSA, OK 74119-5234
(918) 585-1213
(918) 743-8845
Mailing address
3732 S INDIANAPOLIS AVE, 203, TULSA, OK 74135-2285
(405) 565-4496
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/05/2013
Last updated
03/05/2013
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