Individual
NOLAN TYLER GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
501 STATE ST N, WASECA, MN 56093-2811
(507) 835-1210
Mailing address
501 STATE ST N, WASECA, MN 56093-2811
(507) 835-1210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
70677
MN
Other
Enumeration date
04/17/2020
Last updated
08/16/2023
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