Individual
MICHAEL T GREEN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4459 WOODLAND DR APT C, NEW ORLEANS, LA 70131-5810
(504) 930-1540
Mailing address
4459 WOODLAND DR APT C, NEW ORLEANS, LA 70131-5810
(504) 930-1540
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
009459087
LA
Other
Enumeration date
01/16/2021
Last updated
01/16/2021
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