Individual
MR. CLOUD S PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.A.
Contact information
Practice address
3540 E 31ST ST STE 3, TULSA, OK 74135-1526
(918) 749-8378
Mailing address
3540 E 31ST ST STE 3, TULSA, OK 74135-1526
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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