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1255662656
DWAYNE KEVIN DAVID
TAHLEQUAH, OK
NPI
1255662656
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: OK 14525)
Enumeration Date
2010-01-25
Last Update Date
2010-01-25
Business Address
Dr. DWAYNE KEVIN DAVID Pharm. D.
100 S BLISS AVE
TAHLEQUAH, OK 74464-2512
Phone number: 918-458-3105
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Mailing Address
Dr. DWAYNE KEVIN DAVID Pharm. D.
100 S BLISS AVE
TAHLEQUAH, OK 74464-2512
Phone number: 918-458-3105
Copy
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