Individual
LERON REVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8709 E 60TH ST, TULSA, OK 74145-8716
(918) 710-9757
(918) 710-9757
Mailing address
8709 E 60TH ST, TULSA, OK 74145-8716
(918) 710-9757
(918) 710-9757
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/19/2025
Last updated
06/19/2025
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