NPI 1831614361

Lee Clark Green, EMTB

Practitioner Basic Emergency Medical Technician Bloomfield Hills, MI

Practice location

Address: 1410 S Telegraph Rd, Bloomfield Hills, MI 48302-0046
Phone: (248) 456-8150
Mailing address: 2500 Mann Rd Lot 141, Clarkston, MI 48346-4271

Registered specialties

Basic Emergency Medical Technician Primary

Emergency Medical Service Providers Taxonomy 146N00000X Licence 3203058614 (MI)

Other Emergency Medical Technician, Basic providers in Michigan →

Registry record

NPI: 1831614361
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Aug 2017
Record last updated: 5 Aug 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.