Individual
BRENDA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1221 WAUGH CHAPEL RD, GAMBRILLS, MD 21054-1608
(410) 923-2020
Mailing address
2635 RAPTOR DR, ODENTON, MD 21113-3847
(410) 874-8497
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2933
MD
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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