Individual
KELLEE MARIE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 E BROADWAY AVE, THOMAS, OK 73669-8321
(580) 661-3517
(580) 661-3528
Mailing address
118 E BROADWAY AVE, THOMAS, OK 73669-8321
(580) 661-3517
(580) 661-3528
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3117
OK
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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