Individual
JUSTIN JERMAINE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
4412 ELVIS PRESLEY BLVD, MEMPHIS, TN 38116-6408
(901) 830-9256
Mailing address
436 CLARICE DR, MEMPHIS, TN 38109-4626
(901) 830-9256
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
126818
TN
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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