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Individual

DR. GARY WILLIS MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.PH.

Contact information

Practice address
905 S MAIN ST, SHATTUCK, OK 73858-9205
(580) 938-2551
(580) 938-2659
Mailing address
905 S MAIN ST, SHATTUCK, OK 73858-9205
(580) 938-2551
(580) 938-2659

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
10455
KS
183500000X
Pharmacist
Primary
8840
OK

Other

Enumeration date
11/08/2005
Last updated
10/24/2007
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