Individual
EILEEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6216 S LEWIS AVE, SUITE 180, TULSA, OK 74136-1044
(918) 960-7852
Mailing address
10808 E 100TH ST N, OWASSO, OK 74055-6403
(918) 407-0452
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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