Individual
MR. KENDAL REPASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
17100 NAIL CREEK, POTEAU, OK 74953
(918) 721-3923
Mailing address
PO BOX 492, POTEAU, OK 74953-0492
(918) 721-3923
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT480
OK
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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