Individual
DESTINY SPRING DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-1000
Mailing address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-1000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20175
OK
390200000X
Student in an Organized Health Care Education/Training Program
I-10229
OK
Other
Enumeration date
04/21/2023
Last updated
05/09/2024
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