Individual
BETHANY LUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5126 S TRENTON AVE, TULSA, OK 74105-5717
(214) 901-4950
Mailing address
5126 S TRENTON AVE, TULSA, OK 74105-5717
(214) 901-4950
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/04/2014
Last updated
02/04/2014
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