Individual
DR. RYAN MARK GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2021 CLAIBORNE ST, MANDEVILLE, LA 70448-5804
(985) 624-8200
Mailing address
14488 LAKE TAHOE DR, COVINGTON, LA 70433-6951
(225) 810-9058
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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