Individual
RAYMOND DANIEL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
122 2ND AVENUE SE, LIDGERWOOD, ND 58053
(701) 403-4086
Mailing address
PO BOX 13, LIDGERWOOD, ND 58053-0013
(701) 403-4086
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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