Individual provider · Type 1 NPI

Alec Dalton-Shea Puckett

Student in an Organized Health Care Education/Training Program · Tulsa, OK

NPI number 1538836739 Active

Practice location

1215 S Boulder Ave
Tulsa, OK 74119-2842

Call (918) 631-2619 Map

Mailing address

13401 S 87th East Ave
Bixby, OK 74008-3443

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1538836739

Alec Dalton-Shea Puckett's National Provider Identifier is 1538836739, issued on Aug 25, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Tulsa, OK. The record was last updated on Aug 25, 2021.