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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Saturday, May 18, 2024 1:50 PM CDT
Next Update: Saturday, May 18, 2024 4:30 PM CDT

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SHIVE, KELLY JOEL       
Practice Address: 111 N. BAILEY ST.
PRYOR OK 74361

Address last updated on 1/4/2024
Phone #: (918) 824-7770
Fax #:
County: MAYES
License: 1697
Dated: 9/24/2008
Expires: 1/31/2025
Temp. Ltr. Issued: 8/8/2008
Temp. Ltr. Expires: 11/7/2008
License Type: Physical Therapist Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
111 N. BAILEY ST.
PRYOR OK 74361

Phone #: (918) 824-7770
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
CASSIDY CROUCH PT 6251
JULIE ELISE HANCOX PT 5019

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