Provider Information for 1790980118
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KARI DRY
Sex: Female
NPI: 1790980118
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1790980118 | ||||||||
| Enumeration Date | 2007-06-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 558 TAHLEQUAH, OK 74465-0558 United States Phone: 918-775-3081 | Fax:918-775-4935 | ||||||||
| Primary Practice Address | 101 N WHEELER AVE SALLISAW, OK 74955-4617 United States Phone: 918-775-3081 | Fax:918-775-4935 | ||||||||
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