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Individual

JOHN GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1111 SIERRA HWY, ROSAMOND, CA 93560
(661) 754-6622
(661) 256-7678
Mailing address
PO BOX 1205, ROSAMOND, CA 93560-1205
(661) 754-6622
(661) 256-7678

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
N7116688
CA

Other

Enumeration date
12/09/2015
Last updated
10/16/2018
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