Individual
CODY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6039 BERRY ST, FORT SILL, OK 73503-4445
(580) 442-3937
Mailing address
6039 BERRY ST, FORT SILL, OK 73503-4445
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14836
OK
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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