Individual
DR. KELLY GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2500 W NEW ORLEANS ST, BROKEN ARROW, OK 74011-1574
(918) 893-3769
(918) 286-8281
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2887
OK
Other
Enumeration date
07/15/2014
Last updated
03/15/2022
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