Individual
MICHAEL LARRY ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
RR 6, STILWELL, OK 74960-9806
(918) 696-8821
(918) 696-8881
Mailing address
PO BOX 2571, ALMA, AR 72921-2571
(479) 632-5472
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9202
OK
Other
Enumeration date
10/28/2005
Last updated
07/08/2007
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