Individual
JESSICA COLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2029 GORDON COOPER DR, SHAWNEE, OK 74801-9005
(405) 878-5859
(405) 214-4230
Mailing address
2029 GORDON COOPER DR, SHAWNEE, OK 74801-9005
(405) 878-5859
(405) 214-4230
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14790
OK
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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