Individual
MR. MANUEL RIVAS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4513 E 55TH ST, TULSA, OK 74135
(405) 240-1793
Mailing address
4511 E 55TH ST, TULSA, OK 74135-4301
(405) 240-1793
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
OK
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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