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1104090208
KELLY HACKER
OKLAHOMA CITY, OK
NPI
1104090208
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OK 1373)
Enumeration Date
2008-04-18
Last Update Date
2008-04-18
Business Address
Mrs. KELLY HACKER PA-C
750 NE 13TH ST STE 200
OKLAHOMA CITY, OK 73104-5051
Phone number: 405-627-1435
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Mailing Address
Mrs. KELLY HACKER PA-C
750 NE 13TH ST STE 200 P.O. BOX 53188
OKLAHOMA CITY, OK 73104-5051
Phone number: 405-627-1435
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