Ronald W Green JR., PA

NPI #1366432601 in Beaver, West Virginia

Provider Information

NPI Number: 1366432601
Entity Type: Individual
Name: Ronald W Green JR., PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: PA
Enumeration Date: Oct 27, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 703 RITTER DRIVE
City: Beaver
State: West Virginia
ZIP Code: 25813
Phone: (304) 255-1300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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