Most Relevant Information
Provider Data
| NPI Number: | 1003400177 |
| Provider Name: | KELLIE RENEE MARSHALL |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/01/2021 |
| Last Updated: | 03/01/2021 |
Provider Practice Location
3080 W 3RD ST
ELK CITY
OK
736444323
Practice Location Phone/Fax
| Phone: | 5802255136 |
| Fax: |
Provider Mailing Location
4400 N LINCOLN BLVD
OKLAHOMA CITY
OK
731055108
Provider Mailing Phone/Fax
| Phone: | 5802255136 |
| Fax: |