Individual
JARED RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6802 S OLYMPIA AVE STE 300, TULSA, OK 74132-1826
(918) 749-0762
Mailing address
6802 S OLYMPIA AVE STE 300, TULSA, OK 74132-1826
(918) 749-0762
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3021
OK
Other
Enumeration date
01/17/2019
Last updated
01/06/2022
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