BLAINE MATTHEW FIFE

TULSA, OK
NPI1699559633
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2023-08-21
Last Update Date2023-08-21
Business Address
BLAINE MATTHEW FIFE
112 S 64TH WEST AVE
TULSA, OK 74127-5720
Phone number: 918-892-5949
Mailing Address
BLAINE MATTHEW FIFE
112 S 64TH WEST AVE
TULSA, OK 74127-5720
Phone number: 918-892-5949