Individual
JENNY MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD, BCPPS
Contact information
Practice address
1701 E 15TH ST, TULSA, OK 74104-4608
(918) 743-6383
Mailing address
1701 E 15TH ST, TULSA, OK 74104-4608
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17081
OK
Other
Enumeration date
09/30/2022
Last updated
09/30/2022
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