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Laura M Greene

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NPI Number Detailed Information

Provider Information:

Name: Laura M Greene
Gender: F
Provider License Number If Given: 2778P

NPI Information:

NPI: 1831198126
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/19/2005

Last Update Date: 6/6/2013

Provider Business Mailing Address:

Address: 483 S LOOP RD
Edgewood, KY 41017
Phone Number: 8593014600
Fax Number: 8593014601

Provider Business Practice Location Address:

Address: 483 S LOOP RD
Edgewood, KY 41017
Phone Number: 8593014600
Fax Number: 8593014601

Provider Taxonomy:

Primary: 363LF0000X
Secondary (if any):
State: KY

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