Individual
BRYAN TICER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
825 NE 10TH ST STE 2A, OKLAHOMA CITY, OK 73104-5417
(405) 271-6446
(405) 271-6447
Mailing address
825 NE 10TH ST STE 2A, OKLAHOMA CITY, OK 73104-5417
(405) 271-6446
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11952
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11952
STATE BOARD OF PHARMACY LICENSE
OK
Enumeration date
11/16/2017
Last updated
11/16/2017
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