Individual
MALYNN ANNE PUNSALAN ILANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1802 E 19TH ST, TULSA, OK 74104-5403
(918) 634-7500
(918) 634-7560
Mailing address
1802 E 19TH ST, TULSA, OK 74104-5403
(918) 634-7500
(918) 634-7560
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
38222
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/10/2021
Last updated
08/14/2021
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