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Individual

KELSEY M TWO BEARS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
800 W FORREST AVE, EUFAULA, OK 74432-3249
(918) 689-2547
Mailing address
MCN PRIMARY CLINICS, DEPT # 1467, TULSA, OK 74182-0001

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
01/27/2017
Last updated
01/27/2017
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