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Individual

KENNETH LEROY GREEN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7939 W GULF TO LAKE HWY, CRYSTAL RIVER, FL 34429-7931
(352) 257-7874
Mailing address
1101 HAMLIN AVE, HOWEY IN THE HILLS, FL 34737-3706
(352) 516-1347
(813) 354-2497

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
FL

Other

Enumeration date
11/15/2019
Last updated
11/15/2019
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