NPI 1508360595

Kylee Jackson, MEDATCLAT

Practitioner Athletic Trainer Moore, OK

Practice location

Address: 300 N Eastern Ave, Moore, OK 73160-6999
Phone: (405) 735-4700
Mailing address: 9501 S I 35 Service Rd APT 820, Moore, OK 73160-3150

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 888 (OK)

Other Specialist/Technologist providers in Oklahoma →

Registry record

NPI: 1508360595
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Mar 2018
Record last updated: 22 Mar 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.