Individual
RANDALL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
7508 M E CAD BLVD, SUITE A, CLARKSTON, MI 48348-4281
(248) 922-9200
(248) 922-9700
Mailing address
7508 M E CAD BLVD, SUITE A, CLARKSTON, MI 48348-4281
(248) 922-9200
(248) 922-9700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201005754
MI
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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