Provider Demographics
NPI:1225867377
Name:CARROLL, AIMEE (PARAMEDICAL TATTOO)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:PARAMEDICAL TATTOO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12528 S 75TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-6001
Mailing Address - Country:US
Mailing Address - Phone:918-864-9227
Mailing Address - Fax:
Practice Address - Street 1:10137 RIVERSIDE PKWY
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2317
Practice Address - Country:US
Practice Address - Phone:918-864-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty