Individual
TONYA P BALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3956 S HUDSON AVE, TULSA, OK 74135-5608
(918) 622-2406
Mailing address
631 W 11TH ST APT 3, TULSA, OK 74127-9032
(918) 849-3141
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
E081170592
OK
332BC3200X
Customized Equipment (DME)
B081170592
OK
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
E081170592
OK
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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