Individual
KENDALL MEADOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2211 N 14TH ST, PONCA CITY, OK 74601-1841
(580) 765-0101
Mailing address
6 N MISTY ISLE RD, PONCA CITY, OK 74604-7336
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5821
OK
Other
Enumeration date
06/05/2020
Last updated
02/09/2021
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