Individual
JUSTIN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1241 5TH AVE, STEVENS POINT, WI 54481-1726
(715) 310-7937
Mailing address
1241 5TH AVE, STEVENS POINT, WI 54481-1726
(715) 310-7937
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
159681-30
WI
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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