Individual
LESLIE RAY WOODARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH DPH
Contact information
Practice address
301 J T STITES BLVD, SALLISAW, OK 74955-9302
(918) 775-9159
Mailing address
1911 WINTERPARK DR, SALLISAW, OK 74955-7600
(918) 775-6521
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11757
OK
Other
Enumeration date
12/15/2011
Last updated
12/15/2011
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