Healthcare Provider Details

I. General information

NPI: 1831044072
Provider Name (Legal Business Name): KALLI DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALLI MCSPERITT

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 STATE HIGHWAY 17 STE F
ELGIN OK
73538-4517
US

IV. Provider business mailing address

PO BOX 817
ELGIN OK
73538-0817
US

V. Phone/Fax

Practice location:
  • Phone: 580-454-9200
  • Fax:
Mailing address:
  • Phone: 580-454-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: