Individual
ALLISON KATE MODGLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 S BOULDER AVE, TULSA, OK 74119-2842
(918) 631-2619
Mailing address
14409 S 52ND EAST AVE, BIXBY, OK 74008-4036
(918) 740-2164
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/28/2021
Last updated
05/18/2023
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