Susan Diane Green
NPI #1538843354 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1538843354
- Entity Type
- Individual
- Name
- Susan Diane Green
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Jun 12, 2023
- Last Updated
- Jun 20, 2023
Practice Location
- Address
- 307 E COURT ST
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-2019
- Phone
- (217) 370-7852
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist - Prosthetics Case Management — Prosthetics Case Management |
| Prosthetic/Orthotic Supplier |
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