Individual
LAURA GERMAINE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9645 BIG BEND BLVD, SAINT LOUIS, MO 63122-6521
(314) 968-5460
Mailing address
8717 ROSALIE AVE, BRENTWOOD, MO 63144-2027
(314) 497-9409
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
000370
MO
Other
Enumeration date
08/03/2009
Last updated
08/03/2009
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