Individual
KANESHA ELISE RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Mailing address
42879 COUNTY ROAD 570, EUCHA, OK 74342-5054
(918) 264-2837
(918) 256-3628
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/10/2015
Last updated
11/20/2019
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