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Individual

JUSTIN EDCEL TROY S DINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
744 W 9TH ST, TULSA, OK 74127-9907
(918) 599-1000
Mailing address
212 UNION ROAD 779, SMACKOVER, AR 71762-9412

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
20605
OK

Other

Enumeration date
05/26/2025
Last updated
05/26/2025
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