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1184889768
ALAN LEE BROKENICKY
TULSA, OK
NPI
1184889768
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OK 1752)
Enumeration Date
2008-07-23
Last Update Date
2017-01-12
Business Address
-- ALAN LEE BROKENICKY PA
9912 E 21ST ST
TULSA, OK 74129-1620
Phone number: 918-622-0641
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Mailing Address
-- ALAN LEE BROKENICKY PA
1705 E 19TH ST STE 302
TULSA, OK 74104-5410
Phone number: 918-748-7585
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