Most Relevant Information
Provider Data
| NPI Number: | 1003682832 |
| Provider Name: | KATHRYN DIANE EVANS |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 187179 |
Most Important Dates
| Enumeration Date: | 12/01/2023 |
| Last Updated: | 12/01/2023 |
Provider Practice Location
18857 E HIGHWAY 20
CLAREMORE
OK
740193960
Practice Location Phone/Fax
| Phone: | 4796519542 |
| Fax: |
Provider Mailing Location
18857 E HIGHWAY 20
CLAREMORE
OK
740193960
Provider Mailing Phone/Fax
| Phone: | 4796519542 |
| Fax: |