Individual
MARTHA BOON OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 494-2200
Mailing address
2637 E 36TH ST, TULSA, OK 74105-2803
(918) 557-1844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2762
OK
Other
Enumeration date
03/15/2017
Last updated
05/03/2017
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