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1396897625
TRAVIS JAY FREEZE
TALIHINA, OK
NPI
1396897625
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: OK 13609)
Enumeration Date
2007-01-17
Last Update Date
2007-07-08
Business Address
-- TRAVIS JAY FREEZE Pharm D
1 CHOCTAW WAY
TALIHINA, OK 74571-2022
Phone number: 918-567-7000
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Mailing Address
-- TRAVIS JAY FREEZE Pharm D
22599 BLUE BIRD LN
POTEAU, OK 74953-8647
Phone number: 918-567-7000
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