Individual
GINA C KINCHELOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
624 N WASHINGTON AVE, DURANT, OK 74701-3406
(580) 924-5333
(580) 924-5354
Mailing address
PO BOX 819, DURANT, OK 74702-0819
(580) 924-5333
(580) 924-5354
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OK1030
OK
Other
Enumeration date
05/19/2006
Last updated
07/21/2010
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