Individual
PHILLIP LEE KIZZIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
347 S 37TH ST, MUSKOGEE, OK 74401-4906
(918) 683-9729
(918) 683-1012
Mailing address
347 S 37TH ST, MUSKOGEE, OK 74401-4906
(918) 683-9729
(918) 683-1012
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
701503
OK
Other
Enumeration date
01/05/2007
Last updated
07/09/2007
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