Individual
MISS AMANDA NICOLE CAMPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
302 UNIVERSITY PL, DURANT, OK 74701-7110
(580) 920-1145
Mailing address
302 UNIVERSITY PL, DURANT, OK 74701-7110
(580) 920-1145
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14974
OK
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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