Individual
BETH ANN MARIE GREEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
334 MAIN ST, DICKSON CITY, PA 18519-1620
(570) 307-1769
(570) 307-1771
Mailing address
RR 3 BOX 114, DALTON, PA 18414-9415
(570) 378-3242
(570) 307-1771
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TE001143L
PA
Other
Enumeration date
05/03/2006
Last updated
07/08/2007
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