Provider Demographics
NPI:1598449712
Name:LANGDON, TORRI L
Entity Type:Individual
Prefix:
First Name:TORRI
Middle Name:L
Last Name:LANGDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1956 N GARY AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74110-2734
Mailing Address - Country:US
Mailing Address - Phone:918-924-1239
Mailing Address - Fax:
Practice Address - Street 1:1956 N GARY AVE APT 1
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74110-2734
Practice Address - Country:US
Practice Address - Phone:918-924-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist