Individual
ROBERT BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7040 HONEY CREEK RD, OKMULGEE, OK 74447-8628
(918) 759-0263
Mailing address
7040 HONEY CREEK RD, OKMULGEE, OK 74447-8628
(918) 759-0263
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L082168474
DRIVERS LICENSES
OK
Enumeration date
02/20/2023
Last updated
02/20/2023
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