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Individual

BRIAN GREEN GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2620 TENDERFOOT HILL ST STE 10, COLORADO SPRINGS, CO 80906-8354
(719) 527-6747
Mailing address
180 SUN VALLEY DR, WOODLAND PARK, CO 80863-9075
(832) 909-6859

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0025030
CO

Other

Enumeration date
08/06/2024
Last updated
08/06/2024
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