Provider Demographics
NPI:1033634290
Name:HOWL, KELLEY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KELLEY
Middle Name:
Last Name:HOWL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17513 BRAKEN DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-1247
Mailing Address - Country:US
Mailing Address - Phone:405-265-8022
Mailing Address - Fax:
Practice Address - Street 1:17513 BRAKEN DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-1247
Practice Address - Country:US
Practice Address - Phone:405-265-8022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1295580225100000X
OK5609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist