Graduated: 1998
NPI: 1164478541
Practice Locations (3)
1706 DELIVERY LANE
DURANT, OK 747012292
1706 DELIVERY LN
DURANT, OK 747012292
5809202122
OKLAHOMA STATE UNIVERSITY
2345 SOUTHWEST BLVD
TULSA, OK 741072705
9185615701
Source: CMS National Downloadable File, September 2026.