Provider Information for 1831721026
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PAMELA MARIE GREEN
Sex: Female
NPI: 1831721026
Last Updated: 2024-07-04
Certification Date: 2024-07-04
Certification Date: 2024-07-04
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1831721026 | ||||||||
| Enumeration Date | 2020-02-06 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2109 BOSTON PIKE # SR227 RICHMOND, IN 47374-7218 United States Phone: 513-593-3033 | Fax: | ||||||||
| Primary Practice Address | 2109 BOSTON PIKE # SR227 RICHMOND, IN 47374-7218 United States Phone: 513-593-3033 | Fax: | ||||||||
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