Individual
KLOEY LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 US-70 EAST, KINGSTON, OK 73439
(580) 624-6070
Mailing address
419 HARRIS RD, HAWORTH, OK 74740-5138
(918) 974-9264
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5455
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/11/2024
Last updated
01/10/2025
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