Individual
AMY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1901-A MISSION 66, VICKSBURG, MS 39180
(601) 638-4076
Mailing address
PO BOX 822394, VICKSBURG, MS 39182-2394
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4965
MS
Other
Enumeration date
03/24/2014
Last updated
03/24/2014
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