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Individual

MR. ANTWAN DEBOSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8320 S 77TH EAST AVE APT 1166, TULSA, OK 74133-3928
(918) 734-6255
Mailing address
4848 S 129TH EAST AVE, TULSA, OK 74134-7001

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
08/12/2025
Last updated
08/12/2025
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