Individual
LOGAN KRIVANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104-4637
(405) 271-5437
Mailing address
1200 EVERETT DR STE 8305, OKLAHOMA CITY, OK 73104-5047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
OK
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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