Individual
ROBIN ANN WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
1151 N BRYANT AVE, EDMOND, OK 73034-3251
(405) 844-4404
Mailing address
2211 KILEY WAY, EDMOND, OK 73034-3427
(405) 209-5520
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11178
OK
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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