Individual
COURTNEY WELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
18741 E RED FOX TRL, OWASSO, OK 74055-8341
(612) 777-4536
Mailing address
519 W EL PASO ST, BROKEN ARROW, OK 74012-4044
(918) 340-4656
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16121
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16121
BOARD OF PHARMACY
OK
Enumeration date
10/21/2017
Last updated
08/11/2023
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