Individual
AL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
215 S PINE ST, SUITE 201, NEWTON, KS 67114-3765
(316) 283-9977
(316) 283-0966
Mailing address
800 MEDICAL CENTER DRIVE, SUITE 240, NEWTON, KS 67114-3765
(316) 283-9977
(316) 283-0966
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00131
KS
Other
Enumeration date
04/26/2006
Last updated
09/10/2007
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