Individual
KALLY MARIE OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
Mailing address
1813 S MAPLEWOOD AVE, TULSA, OK 74112-7218
(580) 829-1124
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PENDING
—
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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