Individual
CORY MAUPIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7111 S LEWIS AVE, TULSA, OK 74136-5402
(918) 481-0666
Mailing address
7929 E 59TH PL, APT 48-101, TULSA, OK 74145-8632
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15244
OK
Other
Enumeration date
07/31/2012
Last updated
07/31/2012
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