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Individual

MR. KELAND JEROME MASK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
6904 E. RENO AVENUE, MIDWEST CITY, OK 73110-2152
(405) 737-5555
(405) 737-5556
Mailing address
6904 E. RENO AVENUE, MEDWEST CITY, OK 73110-2152
(405) 737-5555
(405) 737-5556

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1821
OK

Other

Enumeration date
05/19/2006
Last updated
07/09/2012
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