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1487240446
LAVARRE GREEN
SAN ANTONIO, TX
NPI
1487240446
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: TX 119090)
Enumeration Date
2020-12-14
Last Update Date
2022-12-27
Business Address
LAVARRE GREEN OTR
9939 FREDERICKSBURG RD APT 1815
SAN ANTONIO, TX 78240-4158
Phone number: 504-300-7425
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Mailing Address
LAVARRE GREEN OTR
9939 FREDERICKSBURG RD APT 1815
SAN ANTONIO, TX 78240-4158
Phone number: 504-300-7425
Copy
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