Individual
KELLY J CHEBAHTAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
31870 E STATE HIGHWAY 51, COWETA, OK 74429-7900
(918) 279-3450
(918) 279-1105
Mailing address
1212 HORN ST, MUSKOGEE, OK 74403-2722
(918) 781-1881
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1350
OK
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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