Individual
LANISHA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 W FRANKLIN ST, APT #4, JACKSON, MI 49201-2379
(517) 392-3242
Mailing address
211 W FRANKLIN ST, APT #4, JACKSON, MI 49201-2379
(517) 392-3242
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
12/19/2016
Last updated
12/19/2016
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