Individual
KELSEY KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 GLENN HENDREN DR, LIBERTY, MO 64068-9625
(913) 642-4900
Mailing address
1923 S UTICA AVE, TULSA, OK 74104-6520
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2017017187
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/18/2016
Last updated
03/17/2018
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