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Individual

LON PRESTON PENNINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.PH.

Contact information

Practice address
1427 N HARRISON ST, SHAWNEE, OK 74801-5245
(405) 273-8520
(405) 273-0542
Mailing address
7648 SW 104TH ST, OKLAHOMA CITY, OK 73169-3802
(405) 745-4470

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11533
OK

Other

Enumeration date
09/21/2011
Last updated
09/21/2011
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