Individual
KALEB BENJAMIN DORRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6216 S LEWIS AVE STE 180, TULSA, OK 74136-1077
(918) 960-7852
Mailing address
7777 S LEWIS AVE, PMB 71-0412, TULSA, OK 74171
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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