Individual
WALTER CRAIG GREEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
259 BILL FRANCE BLVD. SUITE 200, DAYTONA BEACH, FL 32114
(386) 206-8071
Mailing address
1400 SOUTH NOVA RD APT185, DAYTONA BEACH, FL 32114
(386) 334-8969
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/30/2013
Last updated
10/30/2013
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