Individual
MR. MATTHEW AUSTIN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1011 BOWLES AVE STE 150, FENTON, MO 63026-2384
(636) 343-9555
(636) 343-9556
Mailing address
2636 ACCOMAC ST, SAINT LOUIS, MO 63104-2218
(314) 607-7817
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2004004898
MO
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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