Individual
OLIN DAVID GREEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
142 CROSS LANES DR, NITRO, WV 25143-1007
(304) 769-8484
Mailing address
142 CROSS LANES DR, NITRO, WV 25143-1007
(314) 791-1667
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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