Individual
CASSIDY WRAY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
902 E LINCOLN RD, IDABEL, OK 74745-7337
(580) 286-2600
Mailing address
902 E LINCOLN RD, IDABEL, OK 74745-7337
(580) 286-2600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14693
OK
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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