Individual
MR. JASON ROBERT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Contact information
Practice address
62 ROCKFORD RD, WILMINGTON, DE 19806-1047
(302) 428-1021
(302) 428-1034
Mailing address
17 BOLLING CIR, CHADDS FORD, PA 19317-9023
(610) 361-8972
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J10001762
DE
225100000X
Physical Therapist
PT016314
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000030575
—
DE
Enumeration date
08/18/2006
Last updated
07/08/2007
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