Individual
MR. WADE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, ATC, LAT
Contact information
Practice address
2200 HICKORY, ABILENE, TX 79698
(325) 670-1188
Mailing address
2200 HICKORY, ABILENE, TX 79698
(325) 670-5840
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4013
TX
Other
Enumeration date
12/17/2010
Last updated
03/14/2016
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