Individual
KELI ELAINE WHITLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5602 US HWY 59, GROVE, OK 74344
(918) 787-2242
Mailing address
519 W 5TH ST, GROVE, OK 74344-3407
(918) 964-1944
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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