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1497369573
CHARLES IVY
TULSA, OK
NPI
1497369573
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-09-04
Last Update Date
2020-09-04
Business Address
CHARLES IVY
4620 S VANDALIA AVE
TULSA, OK 74135-4715
Phone number: 918-565-7151
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Mailing Address
CHARLES IVY
4620 S VANDALIA AVE
TULSA, OK 74135-4715
Phone number: 918-565-7151
Copy
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