Individual
MARCUS JERMAINE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1544 W 25TH ST, JACKSONVILLE, FL 32209-4282
(904) 616-2764
Mailing address
1544 W 25TH ST, JACKSONVILLE, FL 32209-4282
(904) 616-2764
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
05/27/2022
Last updated
05/27/2022
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