Individual
MR. KEITH JO KANTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
6161 S YALE AVE, XAVIER BUILDING, TULSA, OK 74136-1902
(918) 494-2458
(918) 494-2475
Mailing address
4505 E 103RD ST, TULSA, OK 74137-5946
(918) 298-0545
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0039430
OK
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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