Individual
KEI-A-WANA SELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11428 E 20TH ST, TULSA, OK 74128-6451
(918) 878-7877
(918) 878-7882
Mailing address
3328 N GARRISON AVE, TULSA, OK 74106-1815
(918) 853-5838
(918) 878-7882
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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