Individual
MR. DOCK RUSSELL HUMPHREY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSAJS
Contact information
Practice address
5505 S GARNETT, TULSA, OK 74146
(918) 665-2501
Mailing address
6005 S MADISON AVE, TULSA, OK 74105-8353
(918) 408-6299
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/02/2007
Last updated
03/15/2012
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