Individual
KIMBERLY ANNETTA GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 RED WHEAT DR, CLINTON, OK 73601-5319
(580) 323-0157
(580) 323-7976
Mailing address
2501 RED WHEAT DR, CLINTON, OK 73601-5319
(580) 323-0157
(580) 323-7976
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13425
OK
Other
Enumeration date
03/18/2010
Last updated
03/18/2010
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