Individual
KYLER CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1893 SOUTH WOOD DR, OKMULGEE, OK 74447
(918) 282-6444
Mailing address
1803SOUTH WOOD DR, OKMUKGEE, OK 74447
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/09/2022
Last updated
04/18/2022
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