Individual
JOHN GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7042 JANE PARKS WAY, CHARLOTTE, NC 28217-3670
(612) 747-2576
Mailing address
7042 JANE PARKS WAY, CHARLOTTE, NC 28217-3670
(612) 747-2576
(612) 926-2806
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
000048568756
NC
172A00000X
Driver
VAN7065
NC
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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