Individual
MR. MICHAEL BRIAN GREEN
Active
Individual
MR. MICHAEL BRIAN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1385
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04112007434566
—
WV
Enumeration date
04/11/2007
Last updated
06/08/2016
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