KENNETH DEMASTERS

MOORE, OK
NPI1073696605
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: OK  PA1077)
Enumeration Date2006-10-24
Last Update Date2014-05-29
Business Address
-- KENNETH DEMASTERS
507 NE 12TH ST
MOORE, OK 73160-5807
Phone number: 405-703-4202
Mailing Address
-- KENNETH DEMASTERS
6805 N WOODBROOK RD
WARR ACRES, OK 73132-6413
Phone number:
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