Individual
MR. JOHNNY MARK KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
3604 N CINCINNATI, TULSA, OK 74106-1536
(918) 425-4200
(918) 425-4202
Mailing address
650 S PEORIA, TULSA, OK 74120-4429
(918) 587-9471
(918) 560-0137
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
582
OK
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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