ALEC DALTON-SHEA PUCKETT

TULSA, OK
NPI1538836739
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Additional Taxonomies2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2021-08-25
Last Update Date2021-08-25
Business Address
ALEC DALTON-SHEA PUCKETT
1215 S BOULDER AVE
TULSA, OK 74119-2842
Phone number: 918-631-2619
Mailing Address
ALEC DALTON-SHEA PUCKETT
13401 S 87TH EAST AVE
BIXBY, OK 74008-3443
Phone number: 918-857-5123