Individual
KELSEY LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4502 E 41ST ST, SUITE 2H23, TULSA, OK 74135-2536
(918) 660-3018
Mailing address
10117 S FULTON AVE, TULSA, OK 74137-6047
(620) 330-7680
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
R-15309
OK
Other
Enumeration date
07/29/2013
Last updated
05/29/2015
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