Individual
BLAKE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7101 W HEFNER RD, OKLAHOMA CITY, OK 73162-4503
(405) 773-0711
Mailing address
4409 VALLEY PARK, EDMOND, OK 73025-2959
(405) 340-2545
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10231
OK
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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