Individual
BRETT J BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA-PAC
Contact information
Practice address
1705 E 19TH ST, SUITE 302, TULSA, OK 74104-5405
(918) 748-7599
(918) 748-7539
Mailing address
1705 E 19TH ST, SUITE 302, TULSA, OK 74104-5405
(918) 748-7599
(918) 748-7539
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
999
OK
Other
Enumeration date
10/13/2005
Last updated
07/30/2013
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