Individual
JANE ANN IRELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 E PROSPECT AVE, PONCA CITY, OK 74601-1744
(580) 765-0152
Mailing address
1101 E PROSPECT AVE, PONCA CITY, OK 74601-1744
(580) 765-0152
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8761
OK
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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