Individual
JIM W LUCKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH.
Contact information
Practice address
116 N. MAIN ST., OKEENE, OK 73763
(580) 822-3789
(580) 822-3136
Mailing address
205 N ELM ST, OKEENE, OK 73763-9335
(580) 822-3789
(580) 822-3136
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12644
OK
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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