Most Relevant Information
Provider Data
| NPI Number: | 1003687120 |
| Provider Name: | MCKENZIE PAIGE GADDY |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/09/2024 |
| Last Updated: | 01/09/2024 |
Provider Practice Location
102 N DENVER AVE STE C
TULSA
OK
741031808
Practice Location Phone/Fax
| Phone: | 9185821200 |
| Fax: |
Provider Mailing Location
13693 S 287TH EAST AVE
COWETA
OK
744297024
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |