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Individual

SARAH JAYNE GREENMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
906 SW 14TH ST, WAGONER, OK 74467-7756
(918) 577-1339
Mailing address
906 SW 14TH ST, WAGONER, OK 74467-7756
(918) 577-1339

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1134704489
OK
Enumeration date
10/26/2021
Last updated
10/26/2021
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