Organization
HEALTHY EYES FAMILY VISION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANNY LATRELL GREEN O.D. (MEMBER)
(601) 957-3870
Entity
Organization
Contact information
Practice address
4253 ROBINSON ST, SUITE 105, JACKSON, MS 39209-6530
(601) 922-9272
Mailing address
148 MANCHESTER AVE, JACKSON, MS 39209-2416
(601) 957-3870
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
745
MS
Other
Enumeration date
06/10/2009
Last updated
06/10/2009
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