Individual
TIMOTHY PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4400
Mailing address
549 PARKCREST DR, GRAND PRAIRIE, TX 75052-3170
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/29/2020
Last updated
08/29/2020
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