Individual
KEITH VAN CHLOUBER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
8100 S WALKER AVE, BUILDING B, OKLAHOMA CITY, OK 73139-9402
(405) 602-6565
(405) 602-6587
Mailing address
8100 S WALKER AVE, BUILDING B, OKLAHOMA CITY, OK 73139-9402
(405) 602-6565
(405) 602-6587
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 103
OK
Other
Enumeration date
04/14/2006
Last updated
07/08/2007
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