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Individual

MATTHEW DAVID CRUMPACKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1111 N COMMERCE ST, ARDMORE, OK 73401-3922
(580) 226-6978
(580) 226-7543
Mailing address
PO BOX 353, ARDMORE, OK 73402-0353
(405) 306-6079

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14258
OK

Other

Enumeration date
09/16/2011
Last updated
09/16/2011
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