Individual
BRYAN KIENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7651 S 305TH EAST AVE, BROKEN ARROW, OK 74014-6020
(918) 810-5351
Mailing address
7651 S 305TH EAST AVE, BROKEN ARROW, OK 74014-6020
(918) 810-5351
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
62244
OK
363L00000X
Nurse Practitioner
Primary
62244
OK
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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