Individual
JEANNA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1440 S LEWIS AVE, TULSA, OK 74104-4624
(918) 747-6429
Mailing address
22179 W COYOTE TRL, SAND SPRINGS, OK 74063-4914
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14548
OK
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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