Individual
CARISSA ANN FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4107 S HARVARD AVE, TULSA, OK 74135-2601
(918) 747-6690
Mailing address
26409 E 136TH ST S, COWETA, OK 74429-5898
(918) 361-4776
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17130
OK
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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