Individual
DR. ANDREA J SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
710 E SHAWNTELL SMITH BLVD, MULDROW, OK 74948
(918) 427-3243
(918) 427-6678
Mailing address
PO BOX 1109, MULDROW, OK 74948-1109
(918) 427-3243
(918) 427-6678
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12140
OK
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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