Individual
JENNIFER NICOLE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
74 MIZPAH RD, LOCUST HILL, VA 23092-9808
(804) 824-4748
(804) 824-4748
Mailing address
11313 FARM RD, SALUDA, VA 23149-2853
(276) 232-0155
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306606099
VA
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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