Individual
MR. RAYMOND B GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
1575 ELM ST NE, CONYERS, GA 30012-3715
(770) 864-8806
Mailing address
1575 ELM ST NE, CONYERS, GA 30012-3715
(770) 864-8806
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
12946819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316416860
—
GA
Enumeration date
11/14/2018
Last updated
11/16/2021
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