Individual
GRANT MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6310 S ELM PL, BROKEN ARROW, OK 74011-4100
(918) 455-4386
Mailing address
13818 E 51ST ST APT 2125, TULSA, OK 74134-6778
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21352
OK
Other
Enumeration date
05/13/2026
Last updated
05/13/2026
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