Latricia Pack OD

NPI 1043230477 - Optometrist - 152W00000X

NPI Details
NPI 1043230477
Gender Female
Enumeration Date 07/20/2006
Last Updated 07/31/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
1001 N GRAND AVE
TAHLEQUAH OK, 74464-7017, US
Phone (918) 458-2109
Fax (918) 458-2310
Business Location
1001 N GRAND AVE
TAHLEQUAH OK, 74464-7017, US
Phone (918) 456-5511
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Oklahoma
License Number 2257
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According to our database, Dr. Latricia Pack OD NPI is 1043230477, taxonomy code is 152W00000X and license number is 2257, license state is located at Oklahoma. Latricia Pack OD physically located at 1001 N Grand Ave, Tahlequah OK, 74464-7017. NPI Number Latricia Pack OD has the Individual type.

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1043230477 NPI number is provided on an as is basis without warranty of any kind. 1043230477 is maintained by the National Plan & Provider Enumeration System. The contents of Latricia Pack OD are for informational purposes only.