Individual
KYLE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
701 W HOUSTON ST, BROKEN ARROW, OK 74012-3759
(918) 251-7924
Mailing address
701 W HOUSTON ST, BROKEN ARROW, OK 74012-3759
(918) 251-7924
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15697
OK
Other
Enumeration date
03/24/2015
Last updated
03/24/2015
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