Individual
MRS. MICHELLE LYNN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8085
(907) 376-8802
(907) 376-8842
Mailing address
705 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8085
(907) 376-8802
(907) 376-8842
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/28/2013
Last updated
05/28/2013
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