Lea Williamson Black, PHARMACIST

NPI #1669072047 in Idabel, Oklahoma

Provider Information

NPI Number: 1669072047
Entity Type: Individual
Name: Lea Williamson Black, PHARMACIST
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: PHARMACIST
Enumeration Date: Oct 27, 2020
Last Updated: Oct 27, 2020

Practice Location

Address: 1907 SE WASHINGTON ST
City: Idabel
State: Oklahoma
ZIP Code: 74745-5253
Phone: (580) 286-3323

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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