Individual
BLESSY CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 W VANDAMENT AVE, YUKON, OK 73099-4636
(405) 354-4869
Mailing address
2401 BEAVER BEND LN, YUKON, OK 73099-5157
(863) 514-9961
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16792
OK
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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