PHIL JAMES GREEN

BLACKWELL, OK
NPI1083610752
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: OK  PA800)
Enumeration Date2005-06-27
Last Update Date2007-07-08
Business Address
-- PHIL JAMES GREEN PAC
1009 W FERGUSON AVE
BLACKWELL, OK 74631-5602
Phone number: 580-363-0052
Mailing Address
-- PHIL JAMES GREEN PAC
1009 W FERGUSON AVE
BLACKWELL, OK 74631-5602
Phone number: 580-363-0052
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