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1528572930
TABATHA GREEN
DETROIT, MI
NPI
1528572930
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MI 4703109730)
Enumeration Date
2017-11-21
Last Update Date
2017-11-21
Business Address
TABATHA GREEN LPN
1221 EAST BRAND BLVD
DETROIT, MI 48211
Phone number: 734-458-4601
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Mailing Address
TABATHA GREEN LPN
15740 COYLE ST
DETROIT, MI 48227-2623
Phone number: 313-918-9306
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