Individual
KELLY RAY ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
E.M.T.
Contact information
Practice address
RR 1 BOX 672, BARNSDALL, OK 74002-9736
(918) 847-3491
Mailing address
RR 1 BOX 672, BARNSDALL, OK 74002-9736
(918) 847-3491
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
50468
OK
Other
Enumeration date
12/30/2007
Last updated
12/30/2007
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