Individual
PHILLIP MCKINZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1023 W 3RD ST, ELK CITY, OK 73644-5200
(405) 857-8280
Mailing address
1023 W 3RD ST, ELK CITY, OK 73644-5200
(405) 857-8280
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-497714
OK
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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