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1861681389
MARK BROCKBANK JOHNSON
TULSA, OK
NPI
1861681389
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: OK 90512)
Enumeration Date
2007-10-22
Last Update Date
2007-10-22
Business Address
-- MARK BROCKBANK JOHNSON CRNA
1120 S UTICA AVE
TULSA, OK 74104-4012
Phone number: 918-579-1000
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Mailing Address
-- MARK BROCKBANK JOHNSON CRNA
PO BOX 9188
LONGVIEW, TX 75608-9188
Phone number: 903-663-3600
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