Individual
SHELBY BOLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 E WRANGLER BLVD, SEMINOLE, OK 74868-3518
(405) 382-0201
Mailing address
4712 CHURCHILL, SHAWNEE, OK 74804-1848
(580) 243-8617
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17582
OK
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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