Individual
MR. JONATHAN DAVIS TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3316 E 21ST ST, SUITE C, TULSA, OK 74114-1967
(918) 747-0066
(918) 747-0060
Mailing address
3420 N ATLANTA AVE, TULSA, OK 74110-1537
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3669
OK
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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