Individual
JOHNNY DUANE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 PLAZA, MADILL, OK 73446-2248
(580) 795-7439
Mailing address
PO BOX 1427, ARDMORE, OK 73402-1427
(580) 277-5423
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/26/2010
Last updated
02/26/2010
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