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Individual

KIMBERLY GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1219 K ST NW, ARDMORE, OK 73401-1801
(580) 798-4523
Mailing address
714 CEMETERY RD, MARIETTA, OK 73448-2040
(580) 235-8417

Taxonomy

Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary

Other

Enumeration date
07/09/2014
Last updated
07/09/2014
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