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Individual

JUSTIN LEVI LITTLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
4636 S HARVARD AVE, TULSA, OK 74135-2908
(918) 382-7300
Mailing address
10531 S KOA ST, JENKS, OK 74037-2382
(918) 949-8310

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14911
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14911
STATE LICENSE
OK
Enumeration date
07/01/2018
Last updated
07/01/2018
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  • EDI platform