Individual
MRS. LATONYA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3902 LINDEN DR, ARLINGTON, TX 76017-4637
(972) 660-1920
(817) 563-1272
Mailing address
3902 LINDEN DR, ARLINGTON, TX 76017-4637
(972) 660-1920
(817) 563-1272
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
725107
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
725107
STATE
TX
Enumeration date
04/16/2010
Last updated
04/16/2010
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