Individual
BRYAN EDWARD GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11729 PECKHAM ST, HIRAM, OH 44234-3417
(330) 663-6700
Mailing address
PO BOX 193, HIRAM, OH 44234-0193
(330) 663-6700
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
11/11/2022
Last updated
11/11/2022
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