Individual
MR. AMBROSE GREEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT
Contact information
Practice address
35431 AVALON, ROMULUS, MI 48174
(734) 262-4576
(734) 721-7009
Mailing address
35431 AVALON ST, ROMULUS, MI 48174-1724
(734) 262-4576
(734) 721-7009
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2776
AL
225X00000X
Occupational Therapist
Primary
5201007262
MI
Other
Enumeration date
11/09/2009
Last updated
11/09/2009
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