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General NPI Number Information
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NPI Number | 1023771441
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Entity Type | Individual
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Provider Name | NOELLE LAUREN MOSSMAN DC
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Gender | Female
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 5510 E 41ST ST STE B
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City | TULSA
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State | OK
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Zip | 74135-6037
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Country | US
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Telephone | 918-576-7242
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Fax |
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Provider Business Mailing Address
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Address Line | 9319 E 92ND PL
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City | TULSA
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State | OK
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Zip | 74133-5675
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Country | US
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Telephone | 918-852-4833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4411
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License Number State | OK
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