Individual
KELLY JON GOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
507 W BENEDICT ST, SHAWNEE, OK 74801-6005
(405) 273-6203
(405) 273-6220
Mailing address
507 W BENEDICT ST, SHAWNEE, OK 74801-6005
(405) 273-6203
(405) 273-6220
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1020
OK
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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