Individual
CHARLES J GREENGOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6820 MADRONE DR, ROCKFORD, MI 49341-9578
(480) 313-6777
Mailing address
800 JUDSON AVE APT 201, EVANSTON, IL 60202-2452
(847) 951-3872
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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