Most Relevant Information
Provider Data
| NPI Number: | 1003319161 |
| Provider Name: | KEVIN BERNARD GREEN |
| Entity Type: | Individual |
| Taxonomy Code: | 343900000X |
| Specialty: | Non-emergency Medical Transport (VAN) |
| License Number: | 065153548 |
Most Important Dates
| Enumeration Date: | 03/15/2018 |
| Last Updated: | 03/15/2018 |
Provider Practice Location
10217 WOODLAND HILLS DR
CORDOVA
TN
380186663
Practice Location Phone/Fax
| Phone: | 9017367089 |
| Fax: |
Provider Mailing Location
10217 WOODLAND HILLS DR
CORDOVA
TN
380186663
Provider Mailing Phone/Fax
| Phone: | 9017367089 |
| Fax: |