Provider Information for 1720282783
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KASSIE DUVALL
Sex: Female
NPI: 1720282783
Last Updated: 2008-09-23
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1720282783 | ||||||||
| Enumeration Date | 2007-06-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2325 S HARVARD AVE STE 500 TULSA, OK 74114-3305 United States Phone: 918-732-7560 | Fax:918-587-0419 | ||||||||
| Primary Practice Address | 2325 S HARVARD AVE STE 500 TULSA, OK 74114-3305 United States Phone: 918-732-7560 | Fax:918-587-0419 | ||||||||
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