Individual
LAURA PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
201 NW 63RD ST STE 390, OKLAHOMA CITY, OK 73116-8210
(405) 842-8492
(405) 842-8012
Mailing address
6500 N HENNY RD, JONES, OK 73049-6149
(405) 399-3474
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12808
OK
Other
Enumeration date
09/24/2011
Last updated
09/24/2011
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