Individual
TRAVIS GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATR
Contact information
Practice address
5595 MEMORIAL AVE N, OAK PARK HEIGHTS, MN 55082-1091
(651) 439-4488
Mailing address
8919 JANERO AVE S, COTTAGE GROVE, MN 55016-3419
(651) 214-4593
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1423
MN
Other
Enumeration date
02/11/2007
Last updated
07/08/2007
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