ALAN DWAYNE STATUM

TULSA, OK
NPI1861069379
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
Enumeration Date2021-06-04
Last Update Date2021-06-04
Business Address
Mr. ALAN DWAYNE STATUM OTA
8720 S. 101ST AVE
TULSA, OK 74133
Phone number: 918-965-0101
Mailing Address
Mr. ALAN DWAYNE STATUM OTA
412 E BEAVER ST
JENKS, OK 74037-4513
Phone number: 918-637-4790