| Doctor Name: | MRS. KELLI MICHELLE BENTON |
| NPI Number: | 1316956725 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPT |
| License Number: | 2006002907 |
| Business Practice Address: | 10229 E 96th St N Ste 102 Owasso, OK - 740555305 |
| Business Phone Number: | 9182748541 |
| Business Fax Number: | 9182748560 |
| Mailing Address: | 10229 E 96th St N, Ste 102 OWASSO |
| State: | OK |
| Postal Code: | 740555305 |
| Phone Number: | 9182748541 |
| Fax Number: | 9182748560 |
| NPI Enumeration Date: | 08/05/2006 |
| NPI Last Update Date: | 05/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2006002907 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |