Individual
CORBIN FAIRWEATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9320 N PENNSYLVANIA PL, THE VILLAGE, OK 73120-1519
(405) 840-2105
(405) 840-1731
Mailing address
9320 N PENNSYLVANIA PL, THE VILLAGE, OK 73120-1519
(405) 840-2105
(405) 840-1731
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17955
OK
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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