Individual
KATHRYN DIANE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18857 E HIGHWAY 20, CLAREMORE, OK 74019-3960
(479) 651-9542
Mailing address
18857 E HIGHWAY 20, CLAREMORE, OK 74019-3960
(479) 651-9542
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
187179
OK
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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