Individual
LARRY LANCE BURKART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
2020 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-5439
(918) 456-2437
(918) 456-2458
Mailing address
462041 E 1026 RD, SALLISAW, OK 74955-4075
(918) 619-5362
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12483
OK
Other
Enumeration date
10/31/2020
Last updated
10/31/2020
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