Individual
SHANE BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1823 S JACKSON AVE APT 31J, TULSA, OK 74107-1867
(503) 267-2449
Mailing address
1823 S JACKSON AVE APT 31J, TULSA, OK 74107-1867
(503) 267-2449
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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