Individual
BRANDON JAY TRENTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5350 S PEORIA AVE STE B, TULSA, OK 74105-6820
(918) 749-1991
Mailing address
313 W 119TH ST S, JENKS, OK 74037-3357
(918) 521-7088
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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