Healthcare Provider Details

I. General information

NPI: 1619668829
Provider Name (Legal Business Name): KEHLEY EVE BITZAS OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 S GRANITE AVE
TULSA OK
74136-7039
US

IV. Provider business mailing address

6800 S GRANITE AVE
TULSA OK
74136-7039
US

V. Phone/Fax

Practice location:
  • Phone: 573-541-1028
  • Fax:
Mailing address:
  • Phone: 573-541-1028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: