Individual
LEE CLARK GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EMT-B
Contact information
Practice address
1410 S TELEGRAPH RD, BLOOMFIELD HILLS, MI 48302-0046
(248) 456-8150
Mailing address
2500 MANN RD LOT 141, CLARKSTON, MI 48346-4271
(248) 410-2793
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
3203058614
MI
Other
Enumeration date
08/05/2017
Last updated
08/05/2017
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