Individual
JEFFREY J. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T
Contact information
Practice address
1 ROYAL PARK DR, STE 2, ZEELAND, MI 49464-2242
(616) 772-1370
(616) 772-9774
Mailing address
1 ROYAL PARK DR, STE 2, ZEELAND, MI 49464-2242
(616) 772-1370
(616) 772-9774
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501000893
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G01087
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
01/29/2007
Last updated
03/27/2009
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