Individual
SHELBY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3105
(918) 458-3687
Mailing address
14941 N TRENT ST, TAHLEQUAH, OK 74464-6136
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14882
OK
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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