Individual
DR. BRYAN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
8446 CAMPBELLTON ST, DOUGLASVILLE, GA 30134-1803
(770) 635-8509
(770) 675-7296
Mailing address
8446 CAMPBELLTON ST, DOUGLASVILLE, GA 30134-1803
(770) 635-8509
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH026121
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003175653A
—
GA
Enumeration date
12/23/2020
Last updated
03/19/2021
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