Individual
MR. DANNY LATRELL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4253 ROBINSON ST, JACKSON, MS 39209-6530
(601) 922-9272
Mailing address
6030 WOODLEA RD, JACKSON, MS 39206-2143
(601) 922-9272
(601) 922-8252
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
745
MS
Other
Enumeration date
06/08/2006
Last updated
02/19/2019
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