Kelsy Riann Knoten, | |
2510 Chickasaw Blvd, Ardmore, OK 73401-1341 | |
(580) 226-8181 | |
Not Available |
Full Name | Kelsy Riann Knoten |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 2510 Chickasaw Blvd, Ardmore, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568240885 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Chickasaw Nation Division Of Health Chickasaw Nation Medical Center |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1255364923 PECOS PAC ID: 8426957523 Enrollment ID: O20040108000364 |
Mailing Address | Practice Location Address |
---|---|
Kelsy Riann Knoten, 1921 Stonecipher Dr, Ada, OK 74820-3439 Ph: (580) 421-4570 | Kelsy Riann Knoten, 2510 Chickasaw Blvd, Ardmore, OK 73401-1341 Ph: (580) 226-8181 |
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