Individual
ELLIOT KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
316 S MIDWEST BLVD, MIDWEST CITY, OK 73110-4642
(405) 733-5437
(405) 732-7741
Mailing address
4905 WELLMAN WAY, NORMAN, OK 73072-3705
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
H082956414
OK
Other
Enumeration date
07/28/2014
Last updated
07/28/2014
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