Jonathan Herrick
Student in an Organized Health Care Education/Training Program in Tulsa, OK. Individual provider (NPI-1).
NPI number1083246771
StatusActive
Last updated in NPPESFeb 10, 2020
Details
- NPI
- 1083246771
- Entity type
- Individual (NPI-1)
- Name
- Jonathan Herrick
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 10, 2020
- Certification date
- Feb 10, 2020
- Last updated
- Feb 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
1111 W 17th StTulsa, OK 74107-1886
Phone 918-561-8255
Mailing address
1111 W 17th St # CTulsa, OK 74107-1886
Phone 918-561-8255
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