Individual
LARRY DAVID BRIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1151 N LYNN RIGGS BLVD, CLAREMORE, OK 74017-3068
(918) 283-3784
Mailing address
1151 N LYNN RIGGS BLVD, CLAREMORE, OK 74017-3068
(918) 283-3784
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11352
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100245990A
—
OK
Enumeration date
03/15/2022
Last updated
03/15/2022
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