Individual
DR. KATHLEEN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD.
Contact information
Practice address
3800 W VICKSBURG ST, BROKEN ARROW, OK 74011-1362
(918) 449-8834
Mailing address
3800 W VICKSBURG ST, BROKEN ARROW, OK 74011-1362
(918) 449-8834
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
13063
OK
Other
Enumeration date
07/15/2006
Last updated
07/08/2007
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