Organization
V G GREEN PC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VERNON GARY GREEN OD (OWNER)
(573) 364-6300
Entity
Organization
Contact information
Practice address
1211 HAUCK DR, ROLLA, MO 65401-4900
(573) 364-6300
(573) 341-5058
Mailing address
1211 HAUCK DR, ROLLA, MO 65401-4900
(573) 364-6300
(573) 341-5058
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02294
MO
Other
Enumeration date
05/22/2007
Last updated
02/01/2008
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