Individual
ANDREA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3604 N MARTIN LUTHER KING JR BLVD, TULSA, OK 74106-6447
(918) 425-4200
Mailing address
650 S PEORIA AVE, TULSA, OK 74120-4429
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/10/2014
Last updated
04/10/2014
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