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General NPI Number Information
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NPI Number | 1619197894
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Entity Type | Individual
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Provider Name | KRISTEN LEE HOLCOMB PT
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Gender | Female
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 9322 E. 41 ST
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City | TULSA
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State | OK
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Zip | 74145
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Country | US
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Telephone | 918-628-2534
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Fax |
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Provider Business Mailing Address
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Address Line | 27779 E 112 ST S
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City | COWETA
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State | OK
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Zip | 74429
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Country | US
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Telephone | 918-606-9112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2981
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License Number State | OK
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