Individual
MR. KYLE LEMOINE SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT/L
Contact information
Practice address
2208 N YELLOWOOD AVE, BROKEN ARROW, OK 74012-9102
(918) 286-1261
(918) 286-1265
Mailing address
2208 N YELLOWOOD AVE, BROKEN ARROW, OK 74012-9102
(918) 286-1261
(918) 286-1265
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1367
OK
Other
Enumeration date
11/05/2007
Last updated
07/22/2009
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