MR. Charles Perry Green

NPI #1811266927 in Kamiah, Idaho

Provider Information

NPI Number: 1811266927
Entity Type: Individual
Name: MR. Charles Perry Green
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Health Worker
Enumeration Date: Dec 19, 2011
Last Updated: Dec 19, 2011

Practice Location

Address: 3361 NO KID RD
City: Kamiah
State: Idaho
ZIP Code: 83536-5002
Phone: (208) 553-0284

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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