Individual
MR. HOWARD COLLIN GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1231 NW 79TH ST, OKLAHOMA CITY, OK 73114-1522
(405) 756-0612
Mailing address
1231 NW 79TH ST, OKLAHOMA CITY, OK 73114-1522
(405) 756-0612
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
696
OK
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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