Individual
LARRY D GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1026 RADIO RD, DURANT, OK 74701-2991
(580) 924-7425
Mailing address
1026 RADIO RD, DURANT, OK 74701-2991
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9590
OK
Other
Enumeration date
06/04/2019
Last updated
06/04/2019
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