Individual
SHANNON DON WANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.PH.
Contact information
Practice address
101 N MIDWEST BLVD, MIDWEST CITY, OK 73110-4318
(405) 741-0857
Mailing address
101 N MIDWEST BLVD, MIDWEST CITY, OK 73110-4318
(405) 741-0857
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11879
OK
Other
Enumeration date
10/03/2011
Last updated
10/03/2011
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