Individual
DYLAN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(918) 561-1145
Mailing address
17765 W TRIPLETT RD, CASHION, OK 73016-9694
(405) 708-8992
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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