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Individual

DR. RAYMOND KARL GREENE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
850 W IRONWOOD DR, SUITE 104, COEUR D ALENE, ID 83814-4903
(208) 765-2020
(208) 765-1460
Mailing address
850 W IRONWOOD DR, SUITE 104, COEUR D ALENE, ID 83814-4903
(208) 765-2020
(208) 765-1460

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
845
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002691400
ID
Enumeration date
09/14/2005
Last updated
03/12/2008
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