Individual
DR. WENDELL SHANE EDMONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4300 W MEMORIAL RD, OKLAHOMA CITY, OK 73120-8362
(405) 752-3034
Mailing address
294 COUNTRY TYME DR, OZARK, MO 65721-6503
(417) 343-8484
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12513
OK
183500000X
Pharmacist
2001029138
MO
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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