| NPI | 1194969907 |
|---|---|
| Other Name | KENNETH H. GREEN O.D. |
| Entity Type | Organization |
| Authorized Contact | KENNETH H GREEN Manager 813-286-0433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC1473) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2009-09-18 |