Individual
KAITLYN A MUNGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
205 E B ST, JENKS, OK 74037-3906
(918) 299-4415
Mailing address
16354 W 81ST ST S, SAPULPA, OK 74066-9266
(918) 946-2092
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
896
OK
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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