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Individual

JONATHAN BOMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN-CRNA

Contact information

Practice address
6839 S CANTON AVE, 918-481-5170, TULSA, OK 74136-3402
(918) 494-0612
(918) 481-5170
Mailing address
5515 E 48TH E PL, TULSA, OK 74135

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
89766
OK

Other

Enumeration date
07/17/2014
Last updated
10/08/2015
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