Individual
JONATHAN MICHAEL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNIM
Contact information
Practice address
13 S TEJON ST FL 5, COLORADO SPRINGS, CO 80903-1513
(866) 286-8576
Mailing address
8540 SW ASH MEADOWS RD, 113, WILSONVILLE, OR 97070-4014
(301) 335-4422
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
2612
MD
Other
Enumeration date
08/28/2015
Last updated
08/28/2015
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