Individual
KELLY R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34396 RIVER RD, WHITESBORO, OK 74577-1019
(918) 647-6823
Mailing address
34396 RIVER RD, WHITESBORO, OK 74577-1019
(918) 647-6823
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/17/2011
Last updated
05/17/2011
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