Provider Demographics
NPI:1730741539
Name:NEELEY, KATHERINE (MS, ATC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:NEELEY
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 CYPERT WAY
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-3732
Mailing Address - Country:US
Mailing Address - Phone:580-224-4565
Mailing Address - Fax:
Practice Address - Street 1:3411 CYPERT WAY
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-3732
Practice Address - Country:US
Practice Address - Phone:580-224-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer