Provider Demographics
NPI:1407906340
Name:BRYAN L GREEN
Entity Type:Organization
Organization Name:BRYAN L GREEN
Other - Org Name:POSEY'S HEARING AID CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-632-2213
Mailing Address - Street 1:PO BOX 3090
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95381-3090
Mailing Address - Country:US
Mailing Address - Phone:209-632-2213
Mailing Address - Fax:209-632-3781
Practice Address - Street 1:1000 DELBON AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2008
Practice Address - Country:US
Practice Address - Phone:209-632-2213
Practice Address - Fax:209-632-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA1741237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty