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1245223643
JANA MCCULLOUGH EVENSEN
TAHLEQUAH, OK
NPI
1245223643
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: OK 12811)
Enumeration Date
2005-08-31
Last Update Date
2007-07-08
Business Address
Mrs. JANA MCCULLOUGH EVENSEN DPh
1301 E DOWNING ST
TAHLEQUAH, OK 74464-3350
Phone number: 918-456-1000
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Mailing Address
Mrs. JANA MCCULLOUGH EVENSEN DPh
17841 W 879 RD
PARK HILL, OK 74451-2273
Phone number: 918-457-5275
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