Individual
JOHNELL MONTREY WHAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4919 N ROSEDALE AVE, TULSA, OK 74126-6625
(918) 883-8236
Mailing address
4919 N ROSEDALE AVE, TULSA, OK 74126-6625
(918) 883-8236
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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