Individual
SAMUEL C FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
7608 E 91ST ST, TULSA, OK 74133-6014
(918) 663-0606
Mailing address
7608 E 91ST ST, TULSA, OK 74133-6014
(918) 663-0606
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5962
OK
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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