Individual
JEREMY WADE GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4720 E 21ST ST, TULSA, OK 74114-2109
(918) 392-7025
(918) 392-7029
Mailing address
4720 E 21ST ST, TULSA, OK 74114-2109
(918) 392-7025
(918) 392-7029
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17997
OK
183500000X
Pharmacist
65507
TX
Other
Enumeration date
10/26/2020
Last updated
10/06/2023
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