Individual
MRS. MARIELI BUITRAGO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
726 ELM ST, ARDMORE, OK 73401-1332
(404) 449-8267
Mailing address
726 ELM ST, ARDMORE, OK 73401-1332
(404) 449-8267
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
049220974
IL
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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