Individual
AUSTIN MICHAEL GLENVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8801 S 101ST EAST AVE, TULSA, OK 74133-5716
(918) 294-4000
Mailing address
2029 E 133RD PL S, BIXBY, OK 74008-1080
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
107491
OK
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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