Janiel J Green, PA-C

NPI #1114297660 in Rexburg, Idaho

Provider Information

NPI Number
1114297660
Entity Type
Individual
Name
Janiel J Green, PA-C
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant - Medical
Credential
PA-C
Enumeration Date
Dec 30, 2011
Last Updated
Dec 30, 2011

Practice Location

Address
36 PROFESSIONAL PLZ
Address 2
SUITE #102
State
Idaho
ZIP Code
83440-2049
Phone
(208) 356-0234

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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