Individual
CALLIE KENNISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1680 S GREATHOUSE DRIVE, ATOKA, OK 74525-7452
(580) 297-6965
(580) 324-4181
Mailing address
1775 S GREATHOUSE DR, ATOKA, OK 74525-3434
(580) 889-3553
(580) 324-4181
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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