Individual
BALLAH KEMAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2330 CHANDLER RD, MUSKOGEE, OK 74403-4627
(918) 681-4910
Mailing address
3415 E FAIRMONT PL, BROKEN ARROW, OK 74014-8860
(304) 620-1280
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17286
OK
Other
Enumeration date
08/16/2017
Last updated
08/16/2017
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