Individual
KERIE RYAN KIMBREL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(844) 458-2100
Mailing address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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