Individual
AMY ELAINE GRECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5501 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2074
(405) 604-4380
Mailing address
820 NW 13TH ST, OKLAHOMA CITY, OK 73106-6827
(405) 604-4380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
766
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100125350A
—
OK
Enumeration date
02/10/2006
Last updated
09/22/2016
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