Individual
MR. JERRY MICHAEL BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
906 E MAIN ST, ANTLERS, OK 74523-2808
(580) 298-5064
(580) 298-6144
Mailing address
PO BOX 946, ANTLERS, OK 74523-0946
(580) 298-3673
(580) 298-6144
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8708
OK
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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