Latasha A Green

NPI #1962960740 in Phenix City, Alabama

Provider Information

NPI Number: 1962960740
Entity Type: Individual
Name: Latasha A Green
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Contractor
Enumeration Date: Mar 11, 2019
Last Updated: Mar 11, 2019

Practice Location

Address: 25 KALIN ST
City: Phenix City
State: Alabama
ZIP Code: 36869-3469
Phone: (706) 330-3754

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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