Individual
AMANDA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
529 E MAIN ST, BRIDGEPORT, WV 26330-1824
(304) 842-4204
(304) 842-6480
Mailing address
529 E MAIN ST, BRIDGEPORT, WV 26330-1824
(304) 842-4204
(304) 842-6480
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/10/2010
Last updated
01/09/2013
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