Green's Country Clinic, LLC

NPI #1093240749 in Blackwell, Oklahoma

Provider Information

NPI Number
1093240749
Entity Type
Organization
Organization Name
Green's Country Clinic, LLC
Primary Specialty
Physician Assistant - Medical
Enumeration Date
May 1, 2017
Last Updated
May 1, 2017

Practice Location

Address
223 E BLACKWELL AVE
ZIP Code
74631-2909
Phone
(580) 363-0943

Authorized Official

Name
PHIL GREEN, PA-C
Title
PHYSICIAN ASSISTANT
Phone
(580) 363-0943

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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