Individual
MAYNARD A GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
955 LADERA DR, CARSON CITY, NV 89701-2048
(775) 445-9392
Mailing address
955 LADERA DR, CARSON CITY, NV 89701-2048
(775) 445-9392
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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