Individual
KATHLEEN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
314 S POPLAR ST, SAPULPA, OK 74066-4127
(539) 222-5757
Mailing address
314 S POPLAR ST, SAPULPA, OK 74066-4127
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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