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Individual

MRS. CHERYL DENISE KITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1410 SOUTH GIN ROAD, ATOKA, OK 74525
(580) 889-3399
Mailing address
2358 COUNTY ROAD 1325, BLANCHARD, OK 73010-3522
(405) 485-2185

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200287120A
OK
Enumeration date
09/27/2012
Last updated
10/10/2012
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