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Organization
KEY FUNCTIONAL RESTORATION LLC
Active
Organization
KEY FUNCTIONAL RESTORATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN L BLAYLOCK (MEMBER)
(405) 775-4200
Entity
Organization
Contact information
Practice address
14701 N KELLY AVE, EDMOND, OK 73013-3814
(405) 607-5920
Mailing address
236 NW 62ND ST, OKLAHOMA CITY, OK 73118-7422
(405) 775-4200
(405) 841-9330
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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