Individual
AUTUMN THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST-CSFA
Contact information
Practice address
2408 E 81ST ST, SUITE 900, TULSA, OK 74137-4200
(918) 477-5033
(918) 477-5992
Mailing address
2408 E 81ST ST, SUITE 900, TULSA, OK 74137-4200
(918) 477-5033
(918) 477-5992
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125883
CERTIFICATION NUMBER
OK
Enumeration date
02/13/2014
Last updated
02/13/2014
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