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Individual

DR. CASEY LOGAN OBERSTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD, RPH

Contact information

Practice address
3900 E HILLSIDE DR, BROKEN ARROW, OK 74014-6713
(918) 355-1076
Mailing address
220 W 126TH ST S, JENKS, OK 74037-5202
(607) 372-9039

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18775
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18775
OKLAHOMA BOARD OF PHARMACY
OK
Enumeration date
12/09/2020
Last updated
05/08/2022
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