Individual
MEGAN BLAIRE KASSEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9245 S MINGO RD, TULSA, OK 74133-5793
(918) 574-0250
Mailing address
231 E 21ST ST, TULSA, OK 74114-1201
(918) 277-9105
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2881
OK
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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