Individual
RENE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
42 STATE ST # 1, HEUVELTON, NY 13654-4128
(315) 420-2303
Mailing address
42 STATE ST # 1, HEUVELTON, NY 13654-4128
(315) 420-2303
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032292-01
NY
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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