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1811266927
CHARLES PERRY GREEN
KAMIAH, ID
NPI
1811266927
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
(Licence: ID 003866467)
Enumeration Date
2011-12-19
Last Update Date
2011-12-19
Business Address
Mr. CHARLES PERRY GREEN
3361 NO KID RD
KAMIAH, ID 83536-5002
Phone number: 208-553-0284
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Mailing Address
Mr. CHARLES PERRY GREEN
3361 NO KID RD
KAMIAH, ID 83536-5002
Phone number: 208-553-0284
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