Individual
FASIL DEMERE TSEHAYU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1220 N COMMERCE ST, ARDMORE, OK 73401-1806
(580) 223-1041
Mailing address
3744 W BUCKINGHAM RD APT 171, GARLAND, TX 75042-4723
(469) 422-5343
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18451
OK
183500000X
Pharmacist
63375
TX
Other
Enumeration date
10/21/2022
Last updated
10/21/2022
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