Individual
MR. TODD ERNEST PENDERGRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.PH.
Contact information
Practice address
3359 S ELM PL, BROKEN ARROW, OK 74012-7924
(918) 451-3784
(918) 451-2295
Mailing address
3359 S ELM PL, BROKEN ARROW, OK 74012-7924
(918) 451-3784
(918) 451-2295
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10995
OK
Other
Enumeration date
07/26/2006
Last updated
01/30/2009
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