Individual
KELLY LEANNE MOMQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 779-7216
Mailing address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 779-7216
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
10/11/2022
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