Individual
KATHERINE ELIZABETH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3200 S UNIVERSITY DR, TERRY BUILDING 1402, DAVIE, FL 33328-2018
(954) 262-1402
Mailing address
PO BOX 290370, DAVIE, FL 33329-0370
(954) 262-4397
(952) 262-2269
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG003071
PA
152W00000X
Optometrist
OFC73
FL
Other
Enumeration date
06/21/2015
Last updated
12/08/2015
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