Individual
MR. JODY ALAN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
730 3RD ST, DES MOINES, IA 50309-1302
(515) 564-8746
(515) 564-8741
Mailing address
730 3RD ST, DES MOINES, IA 50309-1302
(515) 564-8746
(515) 564-8741
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001197
IA
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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