Individual
JACKIE LYNN GREENE-GUNTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1855 TANNER WAY, STE 120, HARRIMAN, TN 37748
(865) 882-1535
(865) 882-9497
Mailing address
1855 TANNER WAY, STE 120, HARRIMAN, TN 37748
(865) 882-1535
(865) 882-9497
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0888
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3595618
—
TN
Enumeration date
09/07/2005
Last updated
07/18/2011
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