Individual
KELBY RAE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
625 KENTUCKY ST, ASHLAND, KS 67831-3199
(620) 635-2241
Mailing address
104 BLAKE AVE, MOUNDRIDGE, KS 67107-7513
(620) 960-5633
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-06294
KS
Other
Enumeration date
12/16/2019
Last updated
12/16/2019
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