Kenneth Wayne Dewitt

NPI #1982468047 in Checotah, Oklahoma

Provider Information

NPI Number: 1982468047
Entity Type: Individual
Name: Kenneth Wayne Dewitt
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Feb 9, 2024
Last Updated: Feb 9, 2024

Practice Location

Address: 417759 EAST 1116 RD
City: Checotah
State: Oklahoma
ZIP Code: 74426
Phone: (405) 493-5654

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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