Individual
JANESSA SHAWN DOWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 GARTH BROOKS BLVD # 221, YUKON, OK 73099-4107
(405) 350-0500
(405) 350-0605
Mailing address
1200 GARTH BROOKS BLVD, YUKON, OK 73099-4107
(405) 305-0500
(405) 350-0605
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11506
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11506
DPH LICENSE NUMBER
OK
Enumeration date
11/20/2020
Last updated
11/20/2020
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