Individual
BRYAN HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1725 E 19TH ST, SUITE 202, TULSA, OK 74104-5437
(918) 520-4245
Mailing address
1725 E 19TH ST, SUITE 202, TULSA, OK 74104-5437
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
106611
OK
Other
Enumeration date
11/18/2014
Last updated
01/02/2015
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