Individual
MR. MARTEL MADARIAN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 N RAINBOW BLVD STE 148, LAS VEGAS, NV 89107-1189
(702) 778-8922
(702) 778-8789
Mailing address
101 S RAINBOW BLVD, SUITE 1, LAS VEGAS, NV 89145-5362
(702) 778-8922
(702) 778-8789
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271538272
—
NV
Enumeration date
09/23/2011
Last updated
02/23/2017
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