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Individual

MR. ALEXANDER RYAN GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
7500 SW 30TH ST, DAVIE, FL 33314-1020
(610) 392-9785
Mailing address
1320 SW 82ND TER, APT 423, PLANTATION, FL 33324-3251
(610) 392-9785

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4493
FL
2255A2300X
Athletic Trainer
AT1168
KY

Other

Enumeration date
07/18/2016
Last updated
07/18/2016
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