Individual
MRS. LATRESHA EVANS GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1729 DRIFTWOOD LN, BIRMINGHAM, AL 35235-2981
(205) 706-3012
Mailing address
PO BOX 610114, BIRMINGHAM, AL 35261-0114
(205) 706-3012
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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