Individual
HOLLY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4801 INTEGRIS PKWY, EDMOND, OK 73034-8864
(719) 237-7990
Mailing address
3250 BILLY CT, EDMOND, OK 73034-9347
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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