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1780982983
LISA R TYE
STILWELL, OK
NPI
1780982983
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: OK 11619)
Enumeration Date
2011-03-11
Last Update Date
2011-03-11
Business Address
Mrs. LISA R TYE DPH
RT 6 840
STILWELL, OK 74960
Phone number: 918-696-8800
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Mailing Address
Mrs. LISA R TYE DPH
131 EUBANKS
TAHLEQUAH, OK 74464-8807
Phone number: 918-458-1006
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