Individual
HOLLY JILL WIELIGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1118 PECAN LAKE CT, STILLWATER, OK 74074-1180
(405) 269-3283
Mailing address
1118 PECAN LAKE CT, STILLWATER, OK 74074-1180
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13936
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13936
OK PHARMACY LICENSE
OK
Enumeration date
08/29/2014
Last updated
08/29/2014
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