MR. David Tyler Green, MA, LAT, ATC

NPI #1346213071 in Richmond, Kentucky

Provider Information

NPI Number: 1346213071
Entity Type: Individual
Name: MR. David Tyler Green, MA, LAT, ATC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: MA, LAT, ATC
Enumeration Date: Feb 13, 2006
Last Updated: Aug 8, 2014

Practice Location

Address: 521 LANCASTER AVE. MOBERLY 203
Address 2: EASTERN KENTUCKY UNIVERSITY
City: Richmond
State: Kentucky
ZIP Code: 40475
Phone: (859) 622-2140

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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