Individual
MR. LARRY ALLEN MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
501 NW H ST, STIGLER, OK 74462-1627
(918) 967-8877
(918) 967-8211
Mailing address
1404 NW MIMOSA CIR, STIGLER, OK 74462-1868
(918) 967-8229
(918) 967-8211
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8551
OK
Other
Enumeration date
10/18/2006
Last updated
07/09/2007
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