Individual
BRYAN THOMAS GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1099 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1159
(270) 251-4121
Mailing address
1512 W BROADWAY ST, MAYFIELD, KY 42066-1926
(270) 356-2220
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005132
KY
Other
Enumeration date
04/06/2011
Last updated
04/06/2011
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