Most Relevant Information
Provider Data
| NPI Number: | 1003564303 |
| Provider Name: | LARRY DAVID BRIM |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 11352 |
Most Important Dates
| Enumeration Date: | 03/15/2022 |
| Last Updated: | 03/15/2022 |
Provider Practice Location
1151 N LYNN RIGGS BLVD
CLAREMORE
OK
740173068
Practice Location Phone/Fax
| Phone: | 9182833784 |
| Fax: |
Provider Mailing Location
1151 N LYNN RIGGS BLVD
CLAREMORE
OK
740173068
Provider Mailing Phone/Fax
| Phone: | 9182833784 |
| Fax: |