Individual
KELBY DAWN KOONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1400 E VANBUREN, MCALESTER, OK 74501
(918) 421-6600
Mailing address
101 OKLAHOMA AVE, MCALESTER, OK 74501-7520
(918) 423-4900
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3233
OK
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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