Individual
DR. STACI LYNN TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
1500 E DOWNING ST, TAHLEQUAH, OK 74464-3234
(918) 453-5655
(918) 431-4148
Mailing address
1500 E DOWNING ST, TAHLEQUAH, OK 74464-3234
(918) 453-5655
(918) 431-4148
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14094
OK
Other
Enumeration date
04/27/2015
Last updated
04/27/2015
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