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Individual

ERIC L GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.A.

Contact information

Practice address
257 SW DADE ST, MADISON, FL 32340-2361
(850) 973-3316
(850) 973-1261
Mailing address
3334 CAPITAL MEDICAL BLVD, SUITE 300, TALLAHASSEE, FL 32308-8405
(850) 877-8855
(859) 877-7627

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA23651
FL

Other

Enumeration date
11/06/2012
Last updated
11/06/2012
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