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Individual

GAVIN R GREEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
801 S RANCHO DR, STE F-4, LAS VEGAS, NV 89106-3854
(702) 383-5115
(702) 678-6159
Mailing address
801 S RANCHO DR, STE F-4, LAS VEGAS, NV 89106-3854
(702) 383-5115
(702) 678-6159

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1263
NV

Other

Enumeration date
06/02/2006
Last updated
07/08/2007
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