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General NPI Number Information
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NPI Number | 1699969873
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Entity Type | Individual
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Provider Name | ELISHA RANNELL DOLBOW C.F.A.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 09/06/2007
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Provider Practice Location Address
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Address Line | 8803 S 101ST EAST AVE
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City | TULSA
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State | OK
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Zip | 74133-5726
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Country | US
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Telephone | 918-392-5696
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Fax | 918-392-5697
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Provider Business Mailing Address
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Address Line | 8803 S 101ST EAST AVE STE 383
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City | TULSA
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State | OK
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Zip | 74133-5732
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Country | US
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Telephone | 918-392-5696
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Fax | 918-392-5697
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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 | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 88620
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License Number State | OK
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