Individual
RYAN TACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5350 S PEORIA AVE, TULSA, OK 74105-6839
(918) 749-1991
Mailing address
2003 DORCHESTER DR, LEBANON, TN 37090-8306
(615) 979-3344
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
07/09/2025
Last updated
08/07/2026
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