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STEPHEN ROBERT GREEN
Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1255976551
Individual Registrant: STEPHEN ROBERT GREEN
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1515 LEE RD GUILFORD, VT 05301-8520 US
Tel: 802-258-4833 Fax: --
Tel: 802-258-4833 Fax: --
Contact information for business:
1515 LEE RD GUILFORD, VT 05301-8520 US
Tel: 802-258-4833 Fax: --
Tel: 802-258-4833 Fax: --
Registration Information:
NPI: 1255976551
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist Athletic Trainer |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
