Individual
JEREMY D GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3121 W BROAD ST, COLUMBUS, OH 43204-1306
(614) 869-2002
(614) 792-6240
Mailing address
3121 W BROAD ST, COLUMBUS, OH 43204-1306
(614) 592-9167
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.006347
OH
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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