Individual
CRYSTAL MICHELLE ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1715 N COMMERCE ST, ARDMORE, OK 73401-1535
(580) 226-6444
Mailing address
1715 N COMMERCE ST, ARDMORE, OK 73401-1535
(580) 504-4137
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12441
OK
Other
Enumeration date
11/08/2020
Last updated
11/11/2020
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