Individual
MS. DEANNE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
7330 SHADELAND STA, SUITE 150, INDIANAPOLIS, IN 46256-3957
(317) 621-7728
Mailing address
7330 SHADELAND STA, SUITE 150, INDIANAPOLIS, IN 46256-3957
(317) 621-7728
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002031A
IN
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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