# GREENE SKIN AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225817802
- **Authorized official:** WENDY WHITE (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (304) 688-7027

## Contact information

- **Practice address:** 40 SHAE AVE STE A, CHAPMANVILLE, WV 25508-9805
- **Practice address phone:** (304) 310-2261
- **Practice address fax:** (304) 310-2262
- **Mailing address:** PO BOX 445, DAVIN, WV 25617-0445
- **Mailing address phone:** (304) 310-2261
- **Mailing address fax:** (304) 310-2262

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 09/25/2023
- **Last updated:** 01/02/2024