Organization
GREEN COUNTRY LACTATION LLC
Active
Organization
GREEN COUNTRY LACTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM PARRIS (ADMINISTRATOR/CO-OWNER)
(918) 671-4876
Entity
Organization
Contact information
Practice address
809 W JUNEAU ST, BROKEN ARROW, OK 74012-0765
(918) 671-4876
(918) 744-9657
Mailing address
809 W JUNEAU ST, BROKEN ARROW, OK 74012-0765
(918) 671-4876
(918) 744-9657
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
—
—
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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