Individual
DR. JASON M. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
400 BROADWAY ST, GALENA, IL 61036-1902
(815) 777-0042
Mailing address
1736 HWY 80, CUBA CITY, WI 53807-9708
(563) 209-8583
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.011965
IL
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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