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Individual

MR. LARRY R LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPH

Contact information

Practice address
1631 N 3RD ST, LANGLEY, OK 74350
(918) 782-3271
Mailing address
8170 E 31ST ST, TULSA, OK 74145-1717
(918) 663-2560

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8381
OK

Other

Enumeration date
07/11/2012
Last updated
07/11/2012
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