Individual
MR. PRESTON GREEN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O.T.A.
Contact information
Practice address
5900 FOREST HILLS DR NE, ALBUQUERQUE, NM 87109-4129
(505) 822-6000
Mailing address
413 VISTA ROJA PL NE, RIO RANCHO, NM 87124-1876
(505) 903-0805
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3086
NM
Other
Enumeration date
03/25/2015
Last updated
03/25/2015
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