Individual
MRS. KATHLEEN ROSE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
14185 MACK HARRINGTON DR, CHOCTAW, OK 73020-2035
(405) 390-4495
(405) 390-4745
Mailing address
14101 N DOUGLAS BLVD, JONES, OK 73049-3455
(405) 659-6780
(405) 390-4745
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12499
OK
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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