Individual
DR. MARION DEAN BLOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
26245 HIGHWAY 82, PARK HILL, OK 74451-2802
(918) 431-0505
(918) 431-1155
Mailing address
24143 HIGHWAY 82, PARK HILL, OK 74451-4011
(918) 456-8432
(918) 431-1155
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7352
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7352
STATE PHARMACY LICENSE
OK
Enumeration date
02/20/2007
Last updated
07/08/2007
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