Individual
MARISA LEE BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4400
Mailing address
4444 E 41ST ST, TULSA, OK 74135-2527
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
41659
OK
Other
Enumeration date
04/16/2020
Last updated
10/06/2025
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