Individual
JOSHUA MICHAEL GAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
650 S PEORIA AVE, TULSA, OK 74120-4429
(918) 587-9471
Mailing address
8218 S PEACH AVE, BROKEN ARROW, OK 74011-6113
(918) 527-6314
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
08/17/2018
Last updated
10/11/2022
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