Individual
MS. GRETA J BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.B.O.C.
Contact information
Practice address
5125 SKYLINE RD S, SALEM, OR 97306-9427
(503) 361-5400
Mailing address
6712 SHEPHERD CT N, KEIZER, OR 97303-4338
(503) 371-9690
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
160471
OR
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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