Individual
LISA WILLITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3531 E 4TH ST, TULSA, OK 74112-2613
(918) 402-5226
Mailing address
3531 E 4TH ST, TULSA, OK 74112-2613
(918) 402-5226
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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