Individual
MIKE KIMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.PH.
Contact information
Practice address
801 S BROADWAY ST, MARLOW, OK 73055-3433
(580) 658-3784
(580) 658-3725
Mailing address
801 S BROADWAY ST, MARLOW, OK 73055-3433
(580) 658-3784
(580) 658-3725
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11292
OK
183500000X
Pharmacist
32126
TX
Other
Enumeration date
06/26/2009
Last updated
06/26/2009
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