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1821672858
SCOTT WILLIAM WALLIS
TULSA, OK
NPI
1821672858
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-05-06
Last Update Date
2022-04-04
Business Address
SCOTT WILLIAM WALLIS DO
4502 E 41ST ST
TULSA, OK 74135-2536
Phone number: 918-582-1972
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Mailing Address
SCOTT WILLIAM WALLIS DO
4502 E 41ST ST
TULSA, OK 74135-2536
Phone number:
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