Individual
MR. GLENN H. GILBREATH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.PH.
Contact information
Practice address
2120 S 4TH ST, CHICKASHA, OK 73018-6810
(405) 222-0278
(405) 222-0693
Mailing address
1827 S 14TH ST, CHICKASHA, OK 73018-5409
(405) 224-2858
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10220
OK
Other
Enumeration date
05/30/2007
Last updated
10/31/2009
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