Individual
KELSEY MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(918) 485-0242
Mailing address
10114 E 93RD ST N, OWASSO, OK 74055-6830
(918) 346-2810
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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