Individual
CHRISTOPHER GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT ATC
Contact information
Practice address
3816 N MAIN ST, JACKSONVILLE, FL 32206-1450
(904) 630-6950
Mailing address
3816 N MAIN ST, JACKSONVILLE, FL 32206-1450
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
AL4362
FL
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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