Individual
LARA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6128 E 38TH ST STE 400, TULSA, OK 74135-5808
(918) 835-8691
(918) 836-4505
Mailing address
6128 E 38TH ST STE 400, TULSA, OK 74135-5808
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2924
OK
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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