Individual
JOSEPH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10631 GIBBOUS MOON DR, LAS VEGAS, NV 89129-6493
(310) 920-8632
Mailing address
10631 GIBBOUS MOON DR, LAS VEGAS, NV 89129-6493
(310) 920-8632
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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