Individual
KRISTINA MCANALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2506 N HARRISON ST, SHAWNEE, OK 74804-3131
(405) 214-0300
(405) 214-0301
Mailing address
PO BOX 3675, SHAWNEE, OK 74802-3675
(405) 214-0300
(405) 214-0301
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4687
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568896876
NPI
OK
05
—
200512600A
—
OK
01
—
4687
LICENSE
OK
Enumeration date
08/23/2013
Last updated
06/15/2021
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