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Individual

DR. DARA ANISE BANISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD.

Contact information

Practice address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 482-4781
Mailing address
403 S ROBINSON AVE, MANGUM, OK 73554-4613
(580) 782-2750
(580) 782-5404

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13968
OK

Other

Enumeration date
03/31/2007
Last updated
07/08/2007
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