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Individual

JACOB CODY SANDERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1005 ARLINGTON ST, ADA, OK 74820-4036
(580) 272-0283
(580) 272-0281
Mailing address
1005 ARLINGTON ST, ADA, OK 74820-4036
(580) 272-0283

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19160
OK

Other

Enumeration date
03/10/2021
Last updated
03/10/2021
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