Individual
MR. SAMUEL JAMES MCNULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(918) 561-1181
Mailing address
1111 W 17TH ST, TULSA, OK 74107-1886
(918) 561-1181
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OK
Other
Enumeration date
06/25/2021
Last updated
06/25/2021
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