T G Green Do Sc
NPI #1619279346 in Brookfield, Wisconsin
Provider Information
- NPI Number
- 1619279346
- Entity Type
- Organization
- Organization Name
- T G Green Do Sc
- Primary Specialty
- Family Medicine
- Enumeration Date
- Dec 1, 2010
- Last Updated
- Dec 1, 2010
Practice Location
- Address
- 13760 W CAPITOL DR
- City
- Brookfield
- State
- Wisconsin
- ZIP Code
- 53005-2407
- Phone
- (262) 781-1530
Authorized Official
- Name
- THEODORE G GREEN, D.O.
- Title
- PHYSICIAN
- Phone
- (262) 781-1530
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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