Individual
LAURA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
801 S BROADWAY ST, MARLOW, OK 73055-3433
(580) 658-3784
Mailing address
909 WILLOW BEND DR, MARLOW, OK 73055-3863
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12139
OK
Other
Enumeration date
03/17/2019
Last updated
03/17/2019
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