Reggie Green

NPI #1104914373 in Gonzales, Louisiana

Provider Information

NPI Number
1104914373
Entity Type
Organization
Organization Name
Reggie Green
Primary Specialty
Durable Medical Equipment & Medical Supplies
Enumeration Date
Oct 11, 2006
Last Updated
Apr 29, 2008

Practice Location

Address
105 W CORNERVIEW ST
Address 2
SUITE B
ZIP Code
70737-2839
Phone
(225) 644-6514

Authorized Official

Name
MRS. REGGIE DEMONE GREEN
Title
OWNER
Phone
(225) 644-6514

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies

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