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Individual

MRS. LYNDAL GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
11517 KANIS RD, LITTLE ROCK, AR 72211-3724
(501) 993-8707
(501) 223-8075
Mailing address
5 CHRISTOPHER CV, LITTLE ROCK, AR 72223-2166
(501) 227-0083

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OTR335
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
116021721
AR
Enumeration date
08/04/2008
Last updated
08/04/2008
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