Individual
KIMBERLY J. TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
201 W MAIN ST, DAVIS, OK 73030-1749
(580) 369-3900
(580) 369-3901
Mailing address
1373 OXFORD RD, DAVIS, OK 73030-9306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070019951
IL
225100000X
Physical Therapist
10651
NC
225100000X
Physical Therapist
Primary
5003
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018TE
BLUE CROSS GROUP BILLING NUMBER
NC
Enumeration date
02/05/2007
Last updated
08/26/2021
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