Individual
JIMMIE LEE BROONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
4423 SOUTHWEST BLVD, TULSA, OK 74107-6472
(918) 446-3541
(918) 445-2852
Mailing address
4423 SOUTHWEST BLVD, TULSA, OK 74107-6472
(918) 446-3541
(918) 445-2852
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7919
OK
Other
Enumeration date
06/20/2013
Last updated
06/20/2013
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