Individual
KELLY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
196 SHAWNEE MALL DR, SHAWNEE, OK 74804-1337
(405) 878-0281
Mailing address
201 HARBIN AVE, WAXAHACHIE, TX 75165-2441
(214) 682-5193
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11696
OK
183500000X
Pharmacist
37757
TX
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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