Individual
KELSEY BROOKE TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2301 BELL AVE, ELK CITY, OK 73644-2254
(580) 225-3335
Mailing address
2301 BELL AVE, ELK CITY, OK 73644-2254
(580) 225-3335
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4526
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201302130A
—
OK
01
—
4526
LICENSE
OK
Enumeration date
11/27/2019
Last updated
11/27/2024
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