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Individual

MR. DAVID TYLER GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LAT, ATC

Contact information

Practice address
521 LANCASTER AVE. MOBERLY 203, EASTERN KENTUCKY UNIVERSITY, RICHMOND, KY 40475
(859) 622-2140
(859) 622-8857
Mailing address
146 GENERAL NELSON DR, RICHMOND, KY 40475-8698
(859) 622-2140
(859) 622-8857

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT024
KY

Other

Enumeration date
02/13/2006
Last updated
08/08/2014
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