Individual
AUSTIN SHIRM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
310 FAIRVIEW AVE, PONCA CITY, OK 74601-2001
(580) 762-6335
Mailing address
310 FAIRVIEW AVE, PONCA CITY, OK 74601-2001
(580) 762-6335
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18963
OK
Other
Enumeration date
12/24/2020
Last updated
12/24/2020
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