Individual
KALI MICHELLE GOFORTH I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
231 E GRAHAM AVE, PRYOR, OK 74361-2436
(918) 825-1405
Mailing address
231 E GRAHAM AVE, PRYOR, OK 74361-2436
(918) 232-2844
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
L0071516
OK
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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