Individual
MRS. TIFFANY NOEL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3210 KETHLEY RD, SHAWNEE, OK 74804-9625
(405) 273-9417
Mailing address
3210 KETHLEY RD, SHAWNEE, OK 74804-9625
(405) 273-9417
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15289
OK
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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