SearchOklahoma3336C0003X

Wyatt Lively, D.PH

NPI 1679126627 · on the registry since 2019 · sole proprietor

Practice

Address
128 E Cherokee Ave
Nowata, OK 74048
Phone
(918) 273-3825
Fax
(918) 273-2251
Organisation at this address
The City Drug, Inc.
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
3336C0003X
3336C0003X
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-07-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma