Individual
DR. NICHOLE IARRUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
12802 E 96TH ST N, OWASSO, OK 74055-5371
(918) 272-7467
Mailing address
5727 E 143RD ST S, BIXBY, OK 74008-3734
(580) 980-0425
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14704
OK
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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