Individual
CARL PORTER FUNDERBURK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW CANNIDATE
Contact information
Practice address
5310 E 31ST ST, TULSA, OK 74135-5018
(918) 587-9471
Mailing address
1503 S DENVER AVE, TULSA, OK 74119-3828
(918) 688-9647
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
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