Individual
JOHN WESLEY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1915 D ST, ANTIOCH, CA 94509-2571
(925) 754-3673
Mailing address
1915 D ST, ANTIOCH, CA 94509-2571
(925) 754-3673
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
520763
CA
Other
Enumeration date
03/23/2018
Last updated
03/23/2018
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