Individual
BOMA LEGG-JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-4132
(405) 456-5900
Mailing address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-1000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20707
OK
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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