Individual
THOMAS TANNER CRANDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3108 N BROADWAY ST, POTEAU, OK 74953-5410
(918) 647-2641
(918) 647-8131
Mailing address
2910 WHITE OAK, POTEAU, OK 74953-8797
(918) 839-4588
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17004
OK
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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