Individual
VERNON WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1005 ARLINGTON ST, ADA, OK 74820-4036
(580) 272-0283
Mailing address
19850 COUNTY ROAD 1544, ADA, OK 74820-3156
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8630
OK
Other
Enumeration date
06/21/2017
Last updated
06/21/2017
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