Individual
KATHLEEN MATIE DONICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.,C.
Contact information
Practice address
6048 S SHERIDAN RD, TULSA, OK 74145-9212
(918) 591-3897
Mailing address
9815 S. 239TH E. AVE, BROKNE ARROW, OK 74014
(918) 637-3717
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT100
OK
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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