Individual
BLED MARCHALL TANOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 NW 23RD ST, OKLAHOMA CITY, OK 73107-2644
(405) 943-9899
(405) 943-8994
Mailing address
4400 NW 23RD ST, OKLAHOMA CITY, OK 73107-2644
(405) 943-9899
(405) 943-8994
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17017
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
361924025
TAX
OK
Enumeration date
05/18/2019
Last updated
05/18/2019
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