Individual
JESSICA GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
800 N MAIN ST, ELK CITY, OK 73644-3414
(580) 225-1980
Mailing address
800 N MAIN ST, ELK CITY, OK 73644-3414
(580) 225-1980
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2888
OK
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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