Individual
MARY VONCILLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7305 SE 29TH ST, T-2061, MIDWEST CITY, OK 73110-6122
(405) 455-4001
(405) 455-4204
Mailing address
7305 SE 29TH ST, T-2061, MIDWEST CITY, OK 73110-6122
(405) 455-4001
(405) 455-4204
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10415
OK
Other
Enumeration date
06/06/2011
Last updated
06/06/2011
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