Individual
KARRI GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W MADISON ST, MANGUM, OK 73554-1811
(580) 782-2704
Mailing address
201 W MADISON ST, MANGUM, OK 73554-1811
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100687160A
PUBLIC SCHOOL
OK
Enumeration date
08/31/2015
Last updated
08/31/2015
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