Individual
EDWARD GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1566 BEAVER RIDGE DR, KETTERING, OH 45429-4006
(937) 344-5487
Mailing address
1566 BEAVER RIDGE DR, KETTERING, OH 45429-4006
(937) 344-5487
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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