Individual
KELLTON D'ANDRE DE'WAYNE HOLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6 E LAFAYETTE AVE, COALGATE, OK 74538-2676
(580) 927-3168
Mailing address
6 E LAFAYETTE AVE, COALGATE, OK 74538-2676
(580) 399-5398
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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