Individual
KENDRA MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2475 BOARDWALK, NORMAN, OK 73069-6332
(405) 447-1991
Mailing address
537 SW 93RD ST APT 102, OKLAHOMA CITY, OK 73139-4815
(580) 530-0925
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5171
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200650270A
—
OK
Enumeration date
05/09/2016
Last updated
01/11/2017
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