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Individual

DR. JACK H GREINER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D

Contact information

Practice address
120 W DELAWARE AVE, VINITA, OK 74301-4224
(918) 256-5646
(918) 256-7727
Mailing address
120 W DELAWARE AVE, VINITA, OK 74301-4224
(918) 256-5646
(918) 256-7727

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1156
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3903090001
NSC
OK
Enumeration date
12/20/2006
Last updated
11/06/2014
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