Individual
MELISSA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
911 SW 104TH ST, OKLAHOMA CITY, OK 73139-3009
(405) 692-3866
Mailing address
12901 ELROND DR, OKLAHOMA CITY, OK 73170-2082
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11263
OK
Other
Enumeration date
11/27/2020
Last updated
11/27/2020
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