Individual
ABIGAIL NICOLE SULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2005 N 14TH ST STE 110, PONCA CITY, OK 74601-1919
(580) 762-7444
Mailing address
1409 KAW ST, PERRY, OK 73077-3048
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18894
OK
Other
Enumeration date
12/13/2020
Last updated
12/13/2020
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