Individual
CARSON BLAKE TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2735 ASHE CREEK DR, EDMOND, OK 73034-5948
(405) 513-3079
Mailing address
2735 ASHE CREEK DR, EDMOND, OK 73034-5948
(405) 513-3079
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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