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1083767248
SHANDA R. JACKSON
EDMOND, OK
NPI
1083767248
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: OK 10876)
Enumeration Date
2007-01-19
Last Update Date
2007-07-08
Business Address
-- SHANDA R. JACKSON
2312 WOODFORD WAY
EDMOND, OK 73034-6444
Phone number: 405-340-1611
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Mailing Address
-- SHANDA R. JACKSON
2312 WOODFORD WAY
EDMOND, OK 73034-6444
Phone number: 405-340-1611
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