SHANNON JEWELANNA PRUETT

BROKEN BOW, OK
NPI1033118286
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: OK  12491)
Enumeration Date2005-07-19
Last Update Date2021-01-31
Business Address
Ms. SHANNON JEWELANNA PRUETT D.Ph.
201 S PARK DR
BROKEN BOW, OK 74728-4737
Phone number: 580-584-6085
Mailing Address
Ms. SHANNON JEWELANNA PRUETT D.Ph.
692 OLD MILITARY ROAD
BROKEN BOW, OK 74728-9659
Phone number: 580-584-6089
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