Individual
KELCIE JAYNESAHKLUAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8501 NW MADISCHE RD, LAWTON, OK 73507-1221
(580) 492-3614
Mailing address
8501 NW MADISCHE RD, LAWTON, OK 73507-1221
(580) 492-3614
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45454545
HJKBKHBK
—
Enumeration date
03/07/2023
Last updated
03/07/2023
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