Individual
GRANT SELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2325 S HARVARD AVE, TULSA, OK 74114-3300
(918) 712-4301
Mailing address
9185 E 133RD ST S, BIXBY, OK 74008-3589
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/30/2023
Last updated
03/30/2023
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