Individual
MR. KEVIN JOSEPH GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A
Contact information
Practice address
1450 SCALP AVE, SUITE 106, JOHNSTOWN, PA 15904-3374
(814) 266-8466
(814) 266-0177
Mailing address
105 ALVIN ST, JOHNSTOWN, PA 15904-1833
(814) 266-1544
(814) 266-0177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA002387-L
PA
Other
Enumeration date
05/23/2007
Last updated
04/25/2014
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