Provider First Line Business Practice Location Address:
3126 S HARVARD AVE
Provider Second Line Business Practice Location Address:
DRUG WAREHOUSE #7
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74135-4401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-869-1885
Provider Business Practice Location Address Fax Number:
918-748-0452
Provider Enumeration Date:
06/09/2008