Individual
LEVI CODY MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1911 E JACKSON ST, HUGO, OK 74743-4249
(580) 326-7541
Mailing address
1911 E JACKSON ST, HUGO, OK 74743-4249
(580) 326-7541
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18436
OK
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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