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Individual

BRANDON K GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2120 S 56TH ST, SUITE 204, LINCOLN, NE 68506-2118
(308) 627-3198
Mailing address
2120 S 56TH ST, SUITE 204, LINCOLN, NE 68506-2118

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO03152

Other

Enumeration date
03/01/2012
Last updated
03/01/2012
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