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1093483638
RUSSELL HOLDER
TULSA, OK
NPI
1093483638
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OK 4945)
Enumeration Date
2021-08-30
Last Update Date
2024-02-14
Business Address
RUSSELL HOLDER PA
7818 E 55TH ST
TULSA, OK 74145-7817
Phone number: 918-549-1143
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Mailing Address
RUSSELL HOLDER PA
615 S 32ND ST
MUSKOGEE, OK 74401-5012
Phone number: 539-239-5240
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