Individual
DR. STACEY ANIVA THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3105
(918) 458-3508
Mailing address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3105
(918) 458-3508
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
11876
OK
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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