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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