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Individual

DR. DAKOTA RUSSELL TANNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1212 E CHEROKEE AVE APT A, SALLISAW, OK 74955-5232
(918) 775-4451
(918) 775-5269
Mailing address
1212 E CHEROKEE AVE STE A, SALLISAW, OK 74955-5232
(918) 775-4451
(918) 775-5269

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18497
OK

Other

Enumeration date
02/05/2020
Last updated
05/10/2023
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