Individual
NATHAN LUKE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20993 TOWNLINE RD, CRIDERSVILLE, OH 45806-3101
(419) 371-7854
Mailing address
20993 TOWNLINE RD, CRIDERSVILLE, OH 45806-3101
(419) 371-7854
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
05/24/2024
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