Ina Green, PAC

NPI #1467699025 in Del City, Oklahoma

Provider Information

NPI Number: 1467699025
Entity Type: Individual
Name: Ina Green, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Jan 19, 2009
Last Updated: Jan 19, 2009

Practice Location

Address: 4335 SE 15TH ST
City: Del City
State: Oklahoma
ZIP Code: 73115-3001
Phone: (405) 600-9988

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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