| NPI | 1538474648 |
|---|---|
| Former Name | KELLY JEAN HENDRICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OK 5747) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2021-11-18 |