Individual
VICTORIA VO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
410 S DEWEY AVE, WAGONER, OK 74467-5500
(918) 485-4581
(918) 485-3163
Mailing address
410 S DEWEY AVE, WAGONER, OK 74467-5500
(918) 485-4581
(918) 485-3163
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12713
OK
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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