Individual
AMBER D MATHIAS-HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
1101 E PROSPECT AVE, PONCA CITY, OK 74601-1701
(580) 765-0152
Mailing address
PO BOX 2797, PONCA CITY, OK 74602-2797
(405) 838-6176
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15387
OK
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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