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Individual

MR. CASEY J GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPHT

Contact information

Practice address
3225 E BASELINE RD APT 2102, GILBERT, AZ 85234-2685
(480) 699-7081
Mailing address
3225 E BASELINE RD APT 2102, GILBERT, AZ 85234-2685
(480) 699-7081

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
9012
AZ

Other

Enumeration date
04/26/2007
Last updated
07/08/2007
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