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Individual

JACK D GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
1755 OREGON PIKE, SUITE 200, LANCASTER, PA 17601-4272
(717) 581-5255
(717) 581-5259
Mailing address
1755 OREGON PIKE, SUITE 200, LANCASTER, PA 17601-4272
(717) 581-5255
(717) 581-5259

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW014273
PA

Other

Enumeration date
12/13/2006
Last updated
05/07/2013
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