Individual
LONNELLE ANTONIO GREEN I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
29516 CANVASBACK DR, EASTON, MD 21601-7140
(410) 822-5007
(410) 822-5569
Mailing address
2336 GODDARD PKWY, SALISBURY, MD 21801-1126
(410) 334-6961
(410) 334-6960
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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