Individual
MS. THERESA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANESTHESIOLOGIST AST
Contact information
Practice address
900 PEELER ST, KALAMAZOO, MI 49008-2380
(269) 345-0244
Mailing address
1496 FETKE DR, SAINT JOSEPH, MI 49085-8649
(269) 408-1114
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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