Individual
DENEEN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15814 JEFFERSON DAVIS HWY, SOUTH CHESTERFIELD, VA 23834-5202
(804) 451-1455
(804) 524-2435
Mailing address
15814 JEFFERSON DAVIS HWY, SOUTH CHESTERFIELD, VA 23834-5202
(804) 451-1455
(804) 524-2435
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
361
VA
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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