Lanisha Green

NPI #1023553583 in Jackson, Michigan

Provider Information

NPI Number: 1023553583
Entity Type: Individual
Name: Lanisha Green
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Dec 19, 2016
Last Updated: Dec 19, 2016

Practice Location

Address: 211 W FRANKLIN ST
Address 2: APT #4
City: Jackson
State: Michigan
ZIP Code: 49201-2379
Phone: (517) 392-3242

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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