Individual
KIMBERLY ANN KELLY-LORENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
163 MOHAWK DR, CANADIAN, OK 74425-9747
(918) 339-5800
(918) 339-5801
Mailing address
163 MOHAWK DR, CANADIAN, OK 74425-9747
(918) 339-5800
(918) 339-5801
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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