Individual
KIM TINIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD CCC-A
Contact information
Practice address
2615 E RANDOLPH AVE, ENID, OK 73701-4670
(580) 234-3734
(580) 234-2615
Mailing address
2615 E RANDOLPH AVE, ENID, OK 73701-4670
(580) 234-3734
(580) 234-2615
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2246
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2246
STATE LICENSE NUMBER
KS
Enumeration date
04/07/2014
Last updated
04/07/2014
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