Provider Demographics
NPI:1457573172
Name:OBRITSCH, MARILEE DAWN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARILEE
Middle Name:DAWN
Last Name:OBRITSCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9901 N 120TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-2650
Mailing Address - Country:US
Mailing Address - Phone:918-376-9072
Mailing Address - Fax:918-660-3009
Practice Address - Street 1:4502 E 41ST ST
Practice Address - Street 2:SUITE 2H31
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2553
Practice Address - Country:US
Practice Address - Phone:918-660-3008
Practice Address - Fax:918-660-3009
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK134981835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy