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1386985869
TRAVIS JEREMY NELSON
TULSA, OK
NPI
1386985869
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: OK 5603)
Enumeration Date
2013-03-08
Last Update Date
2016-07-01
Business Address
-- TRAVIS JEREMY NELSON
2345 SOUTHWEST BLVD
TULSA, OK 74107-2705
Phone number: 918-582-1980
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Mailing Address
-- TRAVIS JEREMY NELSON
1910 S FALCON AVE
CLAREMORE, OK 74019-2237
Phone number: 918-582-1980
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