Individual
TAILOR HASTINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9003 N GARNETT RD, OWASSO, OK 74055-4495
(918) 272-2882
Mailing address
1128 S PARKVIEW ST, CLEVELAND, OK 74020-5770
(918) 327-0404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4935
OK
Other
Enumeration date
08/13/2021
Last updated
12/30/2022
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