Individual
LANCE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
3112 S HARVARD AVE, TULSA, OK 74135-4403
(918) 742-2216
Mailing address
8449 E 81ST ST APT 318, TULSA, OK 74133-8046
(580) 302-0628
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15263
OK
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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