Individual
MRS. LACEY MICHELE DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D
Contact information
Practice address
210 S ELM ST, JENKS, OK 74037-3701
(918) 298-2691
(918) 298-2592
Mailing address
210 S ELM ST, JENKS, OK 74037-3701
(918) 298-2691
(918) 298-2592
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14483
OK
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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