Individual
BENNETTE CANADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1055 S HOUSTON AVE, TULSA, OK 74127-9043
(918) 921-3217
Mailing address
1055 S HOUSTON AVE, TULSA, OK 74127-9043
(918) 921-3217
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
54710
OK
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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