Individual
AMANDA MICHELLE GRODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
717 S HOUSTON AVE FL 4, TULSA, OK 74127-9023
(918) 382-4600
Mailing address
1497 E 137TH PL, GLENPOOL, OK 74033-3219
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/13/2018
Last updated
02/13/2018
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