Individual
KELLI KAPRICE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1121 CHANTELL ST, ENID, OK 73703-2940
(580) 484-3059
(580) 234-4237
Mailing address
1121 CHANTELL ST, ENID, OK 73703-2940
(580) 484-3059
(580) 234-4237
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1489
OK
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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