Individual
TIMOTHY GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
310 W 5TH ST, BENTON, KY 42025-1102
(270) 527-1348
(270) 527-9593
Mailing address
310 W 5TH ST, BENTON, KY 42025-1102
(270) 527-1348
(270) 527-9593
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
174010
KY
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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