Individual
DR. JUSTIN BLAKE WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1212A S DOUGLAS BLVD, MIDWEST CITY, OK 73130-5213
(405) 741-1200
(405) 741-1224
Mailing address
3025 ELIE ST, NORMAN, OK 73072-1964
(405) 701-5970
(405) 741-1224
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13059
OK
Other
Enumeration date
09/12/2005
Last updated
07/08/2007
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