Individual
MICHAELANNE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1880 N TRIPLE X RD, CHOCTAW, OK 73020
(405) 834-6432
Mailing address
1880 N TRIPLE X RD, CHOCTAW, OK 73020
(405) 834-6432
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
356
OK
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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