Individual
KENNETH PACK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
512 S. THORTON STREET, VIAN, OK 74962
(918) 773-3025
Mailing address
31179 MOLLY BROWN MT. RD., COOKSON, OK 74427
(918) 781-9994
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3978
OK
Other
Enumeration date
04/29/2010
Last updated
04/29/2010
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