Individual
DANIELLE MARIE GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
304 S PARK LN, ALTUS, OK 73521-5753
(580) 379-6500
(580) 379-6509
Mailing address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5229
OK
363A00000X
Physician Assistant
59518
CA
363A00000X
Physician Assistant
PA10043
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201232170A
—
OK
Enumeration date
11/25/2015
Last updated
03/08/2024
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