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Individual

FAYTH KIMBRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1336 N HARRISON AVE, SHAWNEE, OK 74801-5206
(405) 424-7711
Mailing address
1010 TAYLOR AVE NW, PIEDMONT, OK 73078-7810

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
05/24/2023
Last updated
05/24/2023
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