Individual
KIMBERLY DENSMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
7170 S BRADEN AVE STE 195, TULSA, OK 74136-6324
(918) 280-0090
Mailing address
4909 E 9TH ST, TULSA, OK 74112-4307
(918) 859-9339
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RBT-18-53175
OK
Other
Enumeration date
11/10/2018
Last updated
11/10/2018
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