Individual
JARED GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5808
Mailing address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R72049
AZ
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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