Individual
ADRIEL R. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002735
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001710560
BLUE CROSS BLUE SHIELD
WV
01
—
002097180
BLUE CROSS BLUE SHIELD
WV
01
—
1516805
UMWA
WV
01
—
371681200
FEDERAL WORKERS COMP
—
05
—
3810014501
—
WV
01
—
9241425
AETNA
WV
01
—
P00813687
RR MEDICARE
WV
Enumeration date
01/13/2009
Last updated
05/27/2020
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