Individual
DR. TINA MARIE IMHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
310 FAIRVIEW AVE, PONCA CITY, OK 74601-2001
(580) 762-6335
(580) 762-4210
Mailing address
310 FAIRVIEW AVE, PONCA CITY, OK 74601-2001
(580) 762-6335
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
15419
OK
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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