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Individual

DAVID GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6500 PEARL RD, SUITE # 220, PARMA HEIGHTS, OH 44130-3813
(216) 215-6686
(440) 965-0766
Mailing address
6500 PEARL RD, SUITE # 220, PARMA HEIGHTS, OH 44130-3813

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0063650
OH
Enumeration date
06/16/2016
Last updated
06/16/2016
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