Individual
CARLA BETH BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
13816
OK
3336C0003X
Community/Retail Pharmacy
Primary
225176
OK
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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