Individual
TYLER AUSTIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2900 SW 134TH ST, OKLAHOMA CITY, OK 73170-5403
(405) 300-6446
Mailing address
1012 SW 13TH ST, MOORE, OK 73160-2616
(918) 617-4163
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19332
OK
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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