Individual
DR. JEFFREY NICKLAUS GOLLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1301 N SANTA FE AVE, EDMOND, OK 73003-3603
(405) 340-0522
(405) 359-8853
Mailing address
1301 N SANTA FE AVE, EDMOND, OK 73003-3603
(405) 340-0522
(405) 359-8853
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15449
OK
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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