Individual
SHANNON L RIALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(800) 939-7440
(903) 663-3629
Mailing address
6580 JUDSON RD, LONGVIEW, TX 75605-7076
(800) 939-7440
(214) 382-5417
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
69547
OK
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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