Individual
CORY J GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST/CFA
Contact information
Practice address
1796 CHELAN ST NE, KEIZER, OR 97303-2413
(503) 385-1795
Mailing address
1796 CHELAN ST NE, KEIZER, OR 97303-2413
(503) 385-1795
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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