Individual
MR. MARK S GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
923 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1802
(563) 322-0256
Mailing address
923 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1802
(563) 322-0256
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.039749
IL
183500000X
Pharmacist
18189
IA
Other
Enumeration date
04/04/2012
Last updated
04/04/2012
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