Individual
JENNIFER GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 DAVIS LN STE 106, AUSTIN, TX 78749-3802
(702) 417-6511
Mailing address
1304 LILY TER, AUSTIN, TX 78741-3427
(702) 417-6511
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01794
TX
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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