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NPI 1538891064

NPI 1538891064 : CASEY CRANE AUD : TULSA, OK

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General NPI Number Information
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    NPI Number           |    1538891064
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    Entity Type          |    Individual 
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    Provider Name        |    CASEY CRANE AUD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/24/2022
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    Last Update Date     |    06/24/2022
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Provider Practice Location Address
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    Address Line         |    3105 S HARVARD AVE 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74135-4402
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    Country              |    US
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    Telephone            |    918-508-7601
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    Fax                  |    918-508-7603
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Provider Business Mailing Address
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    Address Line         |    3105 S HARVARD AVE 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74135-4402
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    Country              |    US
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    Telephone            |    918-508-7601
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    Fax                  |    918-508-7603
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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        |    231H00000X
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    Taxonomy Name        |    Audiologist
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    License Number       |    5800
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    License Number State |    OK
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