Individual
ANTHONY GRESHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
SKYLINE EAST II, 6128 E 38TG ST, TULSA, OK 74014
(800) 722-3611
Mailing address
25510 E 90TH PLACE SOUTH, BROKEN ARROW, OK 74014
(910) 770-6700
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/29/2024
Last updated
02/29/2024
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