Individual
DR. RYAN THOMAS BLUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104
(405) 271-4407
Mailing address
1100 NE 13TH ST, OKLAHOMA CITY, OK 73117-1039
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
1188
OK
Other
Enumeration date
03/16/2010
Last updated
06/27/2018
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