Individual
KAYLEIGH MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4809 N TULSA AVE, OKLAHOMA CITY, OK 73112-2243
(940) 882-2372
Mailing address
4809 N TULSA AVE, OKLAHOMA CITY, OK 73112-2243
(940) 882-2372
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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