Individual
OMO OISAMOJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 452-8251
Mailing address
PO BOX 94429, SEATTLE, WA 98124-6729
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2281
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2014
Last updated
10/10/2014
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