Individual
MR. JODY BLAKE WHITE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
2323 S HARVARD AVE, TULSA, OK 74114-3301
(918) 293-2140
Mailing address
8305 S LAKEWOOD PL APT 7, TULSA, OK 74137-2144
(918) 286-9193
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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