Individual
MR. GLENN JOHN SHRADER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
2345 N CLASSEN BLVD, OKLAHOMA CITY, OK 73106-5804
(405) 521-0924
Mailing address
15504 BLUE MESA DR, EDMOND, OK 73013-8848
(405) 850-4837
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14889
OK
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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