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Timothy Blake Poulter, Pharm D.

Pharmacist in Owasso, OK. Individual provider (NPI-1).

NPI number1417469057
StatusActive
Last updated in NPPESNov 3, 2017

Details

NPI
1417469057
Entity type
Individual (NPI-1)
Name
Timothy Blake Poulter
Credential
Pharm D.
Sex
Male
Sole proprietor
No
Enumeration date
Nov 3, 2017
Last updated
Nov 3, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist15221OKYes

Practice location

11815 E 86th St N
Owasso, OK 74055-2536

Phone 918-272-3030

Mailing address

11815 E 86th St N
Owasso, OK 74055-2536

Phone 918-272-3030

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