Individual
KEVIN BERNARD GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10217 WOODLAND HILLS DR, CORDOVA, TN 38018-6663
(901) 736-7089
Mailing address
10217 WOODLAND HILLS DR, CORDOVA, TN 38018-6663
(901) 736-7089
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
065153548
TN
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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