Graduated: 2009
NPI: 1730963596
Practice Locations (2)
KAVANAH MEDICAL LLC
1755 N HWY 66, SUITE G
CATOOSA, OK 740512717
9185531188
PROPHYLAXIS HEALTHCARE LLC
211 S MILL ST, AXIS HEALTHCARE PRYOR 2
PRYOR, OK 743615221
9188253777
Source: CMS National Downloadable File, September 2026.