Individual
ETHAN BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4908 S SHERIDAN RD, TULSA, OK 74145-5712
(918) 984-9153
Mailing address
4908 S SHERIDAN RD, TULSA, OK 74145-5712
(918) 984-9153
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/29/2020
Last updated
09/22/2021
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