Individual
KIMBERLY CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
311 W EXCELSIOR AVE, VINITA, OK 74301-4115
(918) 340-9366
Mailing address
311 W EXCELSIOR AVE, VINITA, OK 74301-4115
(918) 340-9366
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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