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NPI 1215043963

NPI 1215043963 : DALYN DANEE WINTON DPH : ROLAND, OK

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General NPI Number Information
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    NPI Number           |    1215043963
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    Entity Type          |    Individual 
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    Provider Name        |    DALYN DANEE WINTON DPH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/22/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1016 EAST RAY FINE BOULEVARD 
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    City                 |    ROLAND
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    State                |    OK
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    Zip                  |    74954
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    Country              |    US
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    Telephone            |    918-427-0400
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    Fax                  |    918-427-0401
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1202 
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    City                 |    SALLISAW
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    State                |    OK
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    Zip                  |    74955-1202
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    Country              |    US
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    Telephone            |    918-775-4750
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    12740
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    License Number State |    OK
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