Individual
MICHALA HOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
1201 S BRADEN AVE, TULSA, OK 74112-5332
(918) 781-3509
Mailing address
1201 S BRADEN AVE, TULSA, OK 74112-5332
(918) 781-3509
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
198477
OK
363AS0400X
Surgical Physician Assistant
Primary
198477
OK
Other
Enumeration date
11/09/2020
Last updated
11/11/2020
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