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Latresha Evans Green

Specialist, Prosthetics Case Management in Birmingham, AL. Individual provider (NPI-1).

NPI number1194101816
StatusActive
Last updated in NPPESAug 4, 2015

Details

NPI
1194101816
Entity type
Individual (NPI-1)
Name
Mrs. Latresha Evans Green
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 4, 2015
Last updated
Aug 4, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1744P3200X Specialist, Prosthetics Case Management––Yes

Practice location

1729 Driftwood Ln
Birmingham, AL 35235-2981

Phone 205-706-3012

Mailing address

Po Box 610114
Birmingham, AL 35261-0114

Phone 205-706-3012

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